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“I keep pursuing new HIV/AIDS treatments which is why 29 years later, I’m still here.

Brian / HIV/AIDS Researcher James / HIV/AIDS Patient

In the unrelenting push to defeat HIV/AIDS, scientists’ groundbreaking research with brave
patients in trials has produced powerful combination antiretroviral treatments, reducing the death
rate by 87% since they were introduced. Welcome to the future of medicine. For all of us.
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OF NO PA RT Y OR C L IQU E

C O N T E N T S | J U LY/A U G U S T 2 0 1 8
VO L . 3 2 2 – N O. 1

Features

44 The Raid
BY WILLIAM LANGEWIESCHE
Inside a stealth-bomber mission against an ISIS
outpost in Libya

52 Finding the Formula


for Team Chemistry
BY BEN ROWEN
The search for an elixir that turns good teams
into great ones. Does it exist?

T H E H E A LT H R E P O R T

74 Being Black in America Can


Be Hazardous to Your Health
BY OLGA KHA ZAN
Across the United States, African Americans have
a lower life expectancy than whites. In
Baltimore and other segregated cities, this gap is
as much as 20 years. One young woman’s struggle
to get healthy shows why.

COVER STORY

88 Your Child Says She’s


Trans. She Wants Hormones
and Surgery. She’s 13.
BY JESSE SINGAL
For some teens who experience persistent gender
dysphoria, a new protocol ofers profound relief.
For other kids, gender dysphoria is temporary—
and the efects of transitioning can be permanent.

58
When the Next Plague Hits
BY E D YO N G
The epidemics of the early 21st century revealed
a world unprepared, even as the risk of
pandemics continues to multiply. Much worse is
coming. Is Donald Trump prepared?

There’s nothing obviously special about the University of


Nebraska Medical Center’s biocontainment unit. But every detail
has been carefully designed to give patients access to maximal
care, and infectious diseases minimal access to anything.

P h o t o g r a p h by J O N N O R AT T M A N T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 3
CONTENTS VOL . 322–NO. 1 0 7/ 0 8 . 1 8

Dispatches Departments

11 FA M I LY
8 The Conversation
The Dangers of Distracted Parenting
B Y E R I K A C H R I S TA K I S 120 The Big Question
When it comes to children’s development, we should worry What book or article would
less about their screen time—and more about our own. you make required reading
for everyone on Earth?

On the Cover

ST U DY O F ST U D I E S TECHNOLOGY BUSINESS

16 Gossip Is Good 20 These Are the 22 You Buy It,


B Y B E N H E A LY People in Your You Break It
The surprising virtues of Neighborhood BY B RYC E C OV E R T
talking behind people’s backs BY IAN BOGOST Private equity is killing retail.
Nextdoor, a hyperlocal
SKETCH social-media platform, BIG IN ... JAPAN

17 The Trustbuster highlights petty grievances— 24 Dad Classes for


BY ROBINSON MEYER and proves that Americans the Single Guy
Lina Khan has a novel theory have more in common than BY STEPHEN MARCHE
for how monopolies work. they think. Making men more
Her sights are set squarely marriageable, one pregnancy Photograph by
on Amazon. suit at a time Maciek Jasik

4 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
THE ALL-NE W 2019

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CONTENTS VOL . 322–NO. 1 0 7/ 0 8 . 1 8

The Culture File Poetry

THE OMNIVORE BOOKS BOOKS 32 The Unveiling


26 The Wisdom 34 The Wrong 40 Your DNA Is B Y E D WA R D H I R S C H
of Russell Brand Way to Scout for Weirder Than
BY JA M E S PA R K E R Soccer Talent You Think
The recovering addict, BY LAURENT DUBOIS B Y N AT H A N I E L C O M F O R T
comedian, movie star, and An intense winnowing Genetic research constantly
former spouse of Katy Perry process, starting when upends our understanding
has entered a new phase: as players are very young, may of heredity—though not our
the host of a brainy, fail to spot the gifts that are zeal to control it.
philosophical podcast. crucial to the game.

30 MUSIC

The Sound of Rage and Sadness


B Y S P E N C E R KO R N H A B E R
The still-unfolding history of male angst in pop music

Essay

108 Searching for


Jean-Michel Basquiat
BY STEPHEN METCALF
Was he an artist, an art star,
or just a celebrity?

6 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
R E S P O N S E S & R E V E R B E R AT I O N S

solution to this is a constitu-


tional amendment to replace
Section 1 of the Twentieth
Amendment, which set the
inauguration date as January 20.
At the founding of the
republic, travel was diicult.
Particularly in winter, with
atrocious roads, getting from
the hinterlands to the capital
could take a month or more.
Because the votes of the
presidential electors were not
formally certiied by Congress
until well after the election, an
inauguration date of March 4
was speciied. Meanwhile, the
formation of an administration
was relatively trivial. George
Washington had ive Cabinet
oicers (including the vice
president), each of whom had
a handful of clerks, secretaries,
translators, etc. Washington
himself had a few private
secretaries. That was the extent
of the executive branch.
The situation is now
reversed. Washington, D.C.,
can be reached from any
point in the country within a
day’s travel, but forming an
administration of complexity
takes months. Thus, a return to
the original March 4 inaugura-
tion date makes sense. The
amendment efecting such a
change should also include the
provision that the president-
elect could submit Cabinet- and
• T H E C O N V E R S AT I O N
sub-Cabinet-level appoint-
ments to the incoming Senate

The Hardest Job in the World for conirmation prior to the


inauguration. This way, the
In May, John Dickerson laid out the challenges inherent to the presidency—and new administration could start
proposed a series of solutions, from presidential onboarding to vacation time. with much of its infrastructure
in place on day one.
Steven K. Brierley
I thoroughly enjoyed John in favor of professional career whim; and the entire bureau- WESTFORD, MASS.

Dickerson’s disquisition on the positions. For example, we cracy would be more eicient
mismatch between the Oice of could make all sub-Cabinet and better trained. John Dickerson’s very detailed
the President and the president positions part of the civil David So article conirms a suspicion
himself. He is certainly correct service. This would mean the EAST ORANGE, N.J. that I have had for a long
in arguing that the profes- president would appoint only time: The presidency is an
sional demands far outstrip the Cabinet secretaries. John Dickerson identiies the impossible job, and should be
the capabilities of any human The president would be near-impossibility of organiz- divided in half. The president
being. Could I suggest an relieved of much responsi- ing an administration in the would be responsible for
idea? I would like to reduce the bility; policies would not be time between the election and foreign afairs and the military.
number of political appointees subject to so much partisan the inauguration. A possible The vice president would

8 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
be responsible for domestic pronouns throughout the
afairs and economic policy. article. I tried to brush it of, but
Each person would be an decided that I’ll take a hit for
Why Are There So Many Men Here?
expert in his or her respective the team and be “that person.” In May, Caroline Kitchener published an article on
area. The vice president would The presidency, while seem- TheAtlantic.com asking, “Why Do So Few Women Write
no longer be selected merely ingly a male position because Letters to the Editor?” The so-called confidence gap, experts
told her, is one major factor behind the gender disparity in
to “appeal to the base” or only men have illed it thus far, The Atlantic’s inbox and that of other publications. Read-
“balance the ticket.” is actually a gender-neutral job. ers wrote back with their own theories (and prescriptions):
John Nance Garner, Frank- The world is changing “Women don’t need more platforms to speak more often,
louder, in greater numbers, etc. How exhausting. They just
lin D. Roosevelt’s irst vice and growing, and our lan- need men to shut up for a while,” one said. Jen deRose of
president, once commented guage needs to relect that. Irvine, California, ofered: “Women are busy.” Jeanne Lamb-
that “the Vice Presidency is Words matter. Feeling like a kin of Marblehead, Massachusetts, thought that women may
simply have “an extra helping of humility.” Find Kitchener’s
not worth a pitcher of warm welcome part of the conversa- full article—and the subsequent letters—at TheAtlantic.com.
spit.” Perhaps it is time to tion is important.
totally overhaul the job Summer Whitesell
description, and in doing so SEATTLE, WASH. understanding, we should not disconnected realities. The
save the presidency. cede the word reality to irony response to Elon Musk’s
John Bickford or subjectivism. notion that we’re all in a
WALHALLA, S.C. Reality’s End Daniel Story computer simulation, and not
In May, Franklin Foer described GOLETA, CALIF. in the “base reality,” shouldn’t
Okay. It ain’t easy. But compe- how video manipulation is erod- be an ofended cry of anguish;
tent people have accomplished ing society’s ability to agree on Underlying Foer’s prose is it should be a dismissive shrug.
the seemingly impossible with what’s true—or what’s even real. a misguided assumption Who cares? It’s what we’ve
dignity for all but our most that “reality” is something got. That doesn’t get us of the
recent history. John Dicker- Franklin Foer compellingly we have access to or we don’t, hook for what we do with it.
son, don’t try to make excuses foretells the coming “collapse something we can squander or Elias L. Quinn
for a failed president. He is a of reality” that will result from salvage—in short, a commodity. WASHINGTON, D.C.

complete loser, and we are all the degeneration of those This framing misses the lessons
the worse for it. technological mechanisms we of philosophers from the last Is the “collapse of reality” that
Linda Umstead now rely on for the unadul- century, and does damage to Mr. Foer talks about a culmina-
MILILANI, HAWAII terated truth. Yet his choice Foer’s own evident hope that a tion of sorts of the American
of words contributes to the reality can be maintained that idea? If “I’m as good as you
I’m incensed that Dickerson coming of the postmodern hell is inclusive, responsive, and be,” as Emerson described this
didn’t include Hillary Clinton of which he warns. Foer consis- shared among a national or idea, it’s just a short jump to the
in any of his analyses. Like Mitt tently equivocates on the term even global community. notion that my reality’s as good
Romney (whom Dickerson reality, sometimes meaning the Instead of treating reality as yours. Maybe we’ve been
holds up as an example of how objectively true state of things as a commodity, we should collapsing reality these past
to “hit the ground running”), and sometimes meaning our talk about it as a community several centuries.
Clinton spent her campaign shared understanding of the undertaking, an endeavor. It Stephen Sikora
trying to prepare for the oice, objectively true state of things. is collaborative, constantly BORREGO SPRINGS, CALIF.

which she was familiar with Reality in the former sense renegotiated and contested.
because of her husband. She is not under any threat of If it is conceived of as a
won the votes of more people collapse, no matter what the commodity, the politics of Correction:
than Trump did, and yet you internet trolls and dema- power will divvy it out to haves “Will Disney Kill Of the Movie
dismiss her as if she didn’t exist. gogues would have us believe; or have-nots, spark malevo- Theater?” (May) identiied
Janet Smith it is only reality in the latter lence, and drive do-gooders HBO Go as a subscription
HERNDON, VA. sense that is threatened. By to start reality-preservation streaming service. In fact, HBO
equivocating in this way, Foer NGOs. But if reality building Now is the network’s streaming
I am trying to read “The undermines the idea that there is more like gardening than service for cord cutters.
Hardest Job in the World,” is anything beyond our own mining, we can work to make
and ind myself continually idiosyncratic experiences of it expansive rather than rush to To contribute to The
Conversation, please email
distracted and irritated by the the world. If we are to resist turn it into an “ours or theirs” letters@theatlantic.com. Include
overwhelming use of male the collapse of our shared choice of facts with isolating, your full name, city, and state.

E D I T O R I A L O F F I C E S & C O R R E S P O N D E N C E The Atlantic considers unsolicited manuscripts, fiction or nonfiction, and mail for the Letters column. Correspondence should be sent
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T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 9
Take a big, deep breath
clear your head forget you’re here
reading words
on paper
keep reading though
Think back
to the last time
you were in bed
on that perfect mattress
supporting every
bone in your body.
Wait, you don’t have a Casper?
Oh.

F I N D YO U R D R E A M M ATT R E S S
AT CA S P E R . C O M
The fatherhood class in Tokyo is sort of like the prenatal ones I attended when my wife was pregnant—except that none of my classmates is actually a father
or father-to-be. Many of them will list their attendance at this class on their dating profiles with the aim of attracting a partner.
— Stephen Marche, p. 24

D I S P A T C H E S
I D E AS & P R OVO CAT I O N S
J U LY/A U G U S T 2 0 1 8

• FA M I LY

THE DANGERS
OF DISTRACTED
PARENTING
When it comes to
children’s development,
we should worry less
about their screen time—and
more about our own.
B Y E R I K A C H R I S TA K I S

S M A R T P H O N E S H A V E by now
been implicated in so many crummy
outcomes— car fatalities, sleep dis-
turbances, empathy loss, relationship
problems, failure to notice a clown on a
unicycle—that it almost seems easier to
list the things they don’t mess up than the
things they do. Our society may be reach-
ing peak criticism of digital devices.

Illustration by EDMON DE HARO T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 11


D I S PAT C H E S

Even so, emerging research sug- technology expert Linda Stone more system so essential to early learning is
gests that a key problem remains under- than 20 years ago called “continuous interrupted—by a text, for example, or
appreciated. It involves kids’ development, partial attention.” This condition is a quick check-in on Instagram. Any-
but it’s probably not what you think. harming not just us, as Stone has argued; one who’s been mowed down by a
More than screen-obsessed young chil- it is harming our children. The new smartphone-impaired stroller operator
dren, we should be concerned about parental-interaction style can interrupt an can attest to the ubiquity of the phenom-
tuned-out parents. ancient emotional cueing system, whose enon. One consequence of such scenar-
Yes, parents now have more face time hallmark is responsive communication, ios has been noted by an economist who
with their children than did almost any the basis of most human learning. We’re tracked a rise in children’s injuries as
parents in history. Despite a dramatic in uncharted territory.
increase in the percentage of women in
the workforce, mothers today astound- H I L D - development
ingly spend more time caring for their
children than mothers did in the 1960s.
C experts have differ-
ent names for the dyadic This is the worst possible
But the engagement between parent and signaling system between model of parenting—we are
child is increasingly low-quality, even adult and child, which
ersatz. Parents are constantly present in builds the basic archi-
always present physically,
their children’s lives physically, but they tecture of the brain. Jack thereby blocking kids’
are less emotionally attuned. To be clear, P. Shonkoff, a pediatri- autonomy, yet only fitfully
I’m not unsympathetic to parents in this cian and the director of present emotionally.
predicament. My own adult children like Harvard’s Center on the
to joke that they wouldn’t have survived Developing Child, calls
infancy if I’d had a smartphone in my it the “serve and return”
clutches 25 years ago. style of communication;
To argue that parents’ use of screens the psychologists Kathy Hirsh-Pasek and smartphones became prevalent. (AT&T
is an underappreciated problem isn’t to Roberta Michnick Golinkoff describe a rolled out smartphone service at diferent
discount the direct risks screens pose “conversational duet.” The vocal patterns times in diferent places, thereby creating
to children: Substantial evidence sug- parents everywhere tend to adopt during an intriguing natural experiment. Area
gests that many types of screen time exchanges with infants and toddlers are by area, as smartphone adoption rose,
(especially those involving fast-paced or marked by a higher-pitched tone, simpli- childhood ER visits increased.) These
violent imagery) are damaging to young ied grammar, and engaged, exaggerated indings attracted a decent bit of media
brains. Today’s preschoolers spend more enthusiasm. Though this talk is cloying to attention to the physical dangers posed
than four hours a day facing a screen. adult observers, babies can’t get enough by distracted parenting, but we have been
And, since 1970, the average age of onset of it. Not only that: One study showed slower to reckon with its impact on chil-
of “regular” screen use has gone from that infants exposed to this interactive, dren’s cognitive development. “Toddlers
4 years to just four months. emotionally responsive speech style at cannot learn when we break the low of
Some of the newer interactive games 11 months and 14 months knew twice as conversations by picking up our cell-
kids play on phones or tablets may be many words at age 2 as ones who weren’t phones or looking at the text that whizzes
more benign than watching TV (or You- exposed to it. by our screens,” Hirsh-Pasek said.
Tube), in that they better mimic children’s Child development is relational, which In the early 2010s, researchers in
natural play behaviors. And, of course, is why, in one experiment, nine-month- Boston surreptitiously observed 55 care-
many well-functioning adults survived a old babies who received a few hours of givers eating with one or more children
mind-numbing childhood spent watching Mandarin instruction from a live human in fast-food restaurants. Forty of the
a lot of cognitive garbage. (My mother— could isolate speciic phonetic elements adults were absorbed with their phones
unusually for her time—prohibited in the language while another group to varying degrees, some almost entirely
Speed Racer and Gilligan’s Island on the of babies who received the exact same ignoring the children (the research-
grounds of insipidness. That I somehow instruction via video could not. Accord- ers found that typing and swiping were
managed to watch every single episode ing to Hirsh-Pasek, a professor at Tem- bigger culprits in this regard than tak-
of each show scores of times has never ple University and a senior fellow at the ing a call). Unsurprisingly, many of the
been explained.) Still, no one really dis- Brookings Institution, more and more children began to make bids for atten-
putes the tremendous opportunity costs studies are conirming the importance of tion, which were frequently ignored. A
to young children who are plugged in to a conversation. “Language is the single best follow-up study brought 225 mothers and
screen: Time spent on devices is time not predictor of school achievement,” she their approximately 6-year-old children
spent actively exploring the world and told me, “and the key to strong language into a familiar setting and videotaped
relating to other human beings. skills are those back-and-forth fluent their interactions as each parent and
Yet for all the talk about children’s conversations between young children child were given foods to try. During
screen time, surprisingly little attention and adults.” the observation period, a quarter of the
is paid to screen use by parents them- A problem therefore arises when the mothers spontaneously used their phone,
selves, who now suffer from what the emotionally resonant adult–child cueing and those who did initiated substantially

12 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
• FA M I LY

fewer verbal and nonverbal interactions Distracted adults grow irritable when model of parenting imaginable—always
with their child. their phone use is interrupted; they not present physically, thereby blocking
Yet another rigorously designed exper- only miss emotional cues but actually children’s autonomy, yet only fitfully
iment, this one conducted in the Philadel- misread them. A tuned-out parent may present emotionally.
phia area by Hirsh-Pasek, Golinkof, and be quicker to anger than an engaged Fixing the problem won’t be easy,
Temple’s Jessa Reed, tested the impact one, assuming that a child is trying to especially given that it is compounded
of parental cellphone use on children’s be manipulative when, in reality, she by dramatic changes in education. More
language learning. Thirty-eight mothers just wants attention. Short, deliber- young children than ever (about two-
and their 2-year-olds were brought into a ate separations can of course be harm- thirds of 4-year-olds) are in some form
room. The mothers were then told that less, even healthy, for parent and child of institutional care, and recent trends
they would need to teach their children alike (especially as children get older in early-childhood education have illed
two new words (blicking, which was to and require more independence). But many of their classrooms with highly
mean “bouncing,” and frepping, which that sort of separation is diferent from scripted lessons and dull, one-sided
was to mean “shaking”) and were given the inattention that occurs when a par- “teacher talk.” In such environments, chil-
a phone so that investigators could con- ent is with a child but communicating dren have few opportunities for sponta-
tact them from another room. When through his or her nonengagement that neous conversation.
the mothers were interrupted by a call, the child is less valuable than an email. One piece of good news is that young
the children did not learn the word, but A mother telling kids to go out and play, children are prewired to get what they
otherwise they did. In an ironic coda to a father saying he needs to concentrate need from adults, as most of us discover
this study, the researchers had to exclude on a chore for the next half hour—these the irst time our diverted gaze is jerked
seven mothers from the analysis, because are entirely reasonable responses to the back by a pair of pudgy, reproaching
they didn’t answer the phone, “failing to competing demands of adult life. What’s hands. Young children will do a lot to
follow protocol.” Good for them! going on today, however, is the rise of get a distracted adult’s attention, and if
unpredictable care, governed by the we don’t change our behavior, they will
T H A S N E V E R been easy to bal- beeps and enticements of smartphones. attempt to do it for us; we can expect
I ance adults’ and children’s needs,
much less their desires, and it’s naive to
We seem to have stumbled into the worst to see a lot more tantrums as today’s

imagine that children could ever be the


unwavering center of parental attention.
Parents have always left kids to entertain • V E RY S H O R T B O O K E XC E R P T
themselves at times—“messing about
in boats,” in a memorable phrase from
The Wind in the Willows, or just lounging
Castro’s Ice-Cream Headache
aimlessly in playpens. In some respects,
L I K E WA S H I N G T O N A N D J E F F E R S O N , the found-
21st-century children’s screen time is not
ing father of the Cuban Revolution, Fidel Castro,
very diferent from the mother’s helpers
loved ice cream. His friend Gabriel García Márquez,
every generation of adults has relied on
the Colombian novelist, recalled in “A Personal
to keep children occupied. When parents
Portrait of Fidel” that the leader once concluded
lack playpens, real or proverbial, may-
a large lunch by eating 18 scoops of ice cream.
hem is rarely far behind. Caroline Fra-
According to CIA documents declassified in 2007,
ser’s recent biography of Laura Ingalls
the CIA noticed Castro’s ice-cream fetish and tried,
Wilder, the author of Little House on
unsuccessfully, to plant a poison pill in his favorite
the Prairie, describes the exceptionally
chocolate milkshake. Apparently the assassin
ad hoc parenting style of 19th-century stored the pill in an ice-cream freezer, and it got
frontier parents, who stashed babies on stuck and fell apart when he tried to take it out.
the open doors of ovens for warmth and
otherwise left them vulnerable to “all
manner of accidents as their mothers
tried to cope with competing responsibili-
ties.” Wilder herself recounted a variety
of near-calamities with her young daugh-
ter, Rose; at one point she looked up from
her chores to see a pair of riding ponies
leaping over the toddler’s head.
Occasional parental inattention is not
catastrophic (and may even build resil-
ience), but chronic distraction is another Adapted from Milk! A 10,000-Year Food Fracas, by
story. Smartphone use has been associ- Mark Kurlansky, published by Bloomsbury in May
ated with a familiar sign of addiction:

Illustration by JOE MCKENDRY T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 13


This content was created by Atlantic Re:think, the branded content studio at The Atlantic, and made
SPONSOR CONTENT possible by Fidelity Investments. It does not necessarily reflect the views of The Atlantic’s editorial staff.

Which Disruptions
Really Matter?
It seems as though every day brings
about the next big, revolutionary
technology. How do we figure out
which ones hold actual potential?

KEEPING UP WITH THE L ATEST tech trends


can feel like a full-time job. But for investors,
it’s not enough just to keep up; they
have to determine which innovations offer
meaningful opportunity and which are
simply passing fads. Sometimes, it helps
to hear from the experts.

This season on The Future According to


Now, we’ll talk to investment experts about
nine key sectors facing technological
disruption and about the potential investment
opportunities within them.

From a smart thermometer that can predict—


>`«ÃÃLÞi>ÌipÌiyÕÌiÝ«>`i`
e-commerce in emerging markets and
spacecraft that can take off and land on
runways as airplanes do, future technologies
hold a lot of promise for changing our lives—
just not always in the ways you may expect.
SPONSOR CONTENT

Ground-breaking innovations have real potential to change


our lives in the foreseeable future—and not always in
the ways you’d imagine. When Fidelity’s investment experts
consider this potential, they look well beyond the obvious
implications. The Future According to Now is a podcast
from Atlantic Re:think, the branded content studio at The
Atlantic, and Fidelity Investments. Follow along at
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hearing a piece of nega-
D I S PAT C H E S
tive gossip, the more likely
• ST U DY O F ST U DI E S they were to say they
had learned a lesson
toddlers age into school. But eventually,
from it. [7] Negative
children may give up. It takes two to tango,
and studies from Romanian orphanages
Gossip Is Good gossip can also have a
The surprising virtues of prosocial efect on those
showed the world that there are limits to who are gossiped about.
what a baby brain can do without a will- talking behind people’s backs Researchers at Stanford
ing dance partner. The truth is, we don’t and UC Berkeley found
B Y B E N H E A LY
really know how much our kids will sufer that once people were
when we fail to engage. ostracized from a group
Of course, adults are also suffering due to reputed selfishness,
from the current arrangement. Many

W
ORD ON the timeliness (T) times its they reformed their ways
have built their daily life around the mis- street is that interest (I) to the power of in an attempt to regain
erable premise that they can always be gossip is the its unverifiability (v) minus the approval of the people
on—always working, always parenting, worst. An Ann Landers the reluctance someone they had alienated. [8]
always available to their spouse and their advice column once char- might feel about repeating By far the most positive
own parents and anyone else who might acterized it as “the face- it out of taste (t). [3] assessment of gossip,
need them, while also staying on top of less demon that breaks Despite gossip’s dodgy though, comes courtesy
the news, while also remembering, on the hearts and ruins careers.” reputation, a surpris- of the anthropologist and
walk to the car, to order more toilet paper The Talmud describes it as ingly small share of it—as evolutionary psycholo-
from Amazon. They are stuck in the digi- a “three-pronged tongue” little as 3 to 4 percent—is gist Robin Dunbar. Once
tal equivalent of the spin cycle. that kills three people: the actually malicious. [4] upon a time, in Dunbar’s
Under the circumstances, it’s easier teller, the listener, and the And even that portion can account, our primate
to focus our anxieties on our children’s person being gossiped bring people together. ancestors bonded through
screen time than to pack up our own about. And Blaise grooming, their mutual
devices. I understand this tendency Pascal observed, not back-scratching ensur-
all too well. In addition to my roles as unreasonably, that “if ing mutual self-defense
a mother and a foster parent, I am the people really knew what in the event of attack by
maternal guardian of a middle-aged, others said about them, predators. But as hominids
overweight dachshund. Being middle- there would not be four grew more intelligent and
aged and overweight myself, I’d much friends left in the world.” more social, their groups
rather obsess over my dog’s caloric Convincing as became too large to unite
intake, restricting him to a grim diet of these indictments by grooming alone. That’s
ibrous kibble, than address my own food seem, however, where language—and
regimen and relinquish (heaven forbid) a significant body of re- Researchers at the Univer- gossip, broadly defined—
my morning cinnamon bun. Psycho- search suggests that gos- sity of Texas and the Uni- stepped in. [9] Dunbar
logically speaking, this is a classic case sip may in fact be healthy. versity of Oklahoma found argues that idle chatter
It’s a good thing, too, that if two people share with and about others
of projection— the defensive displace-
since gossip is pretty per- negative feelings about gave early humans a sense
ment of one’s failings onto relatively
vasive. Children tend to be a third person, they are of shared identity and
blameless others. Where screen time is
seasoned gossips by the likely to feel closer to each helped them grow more
concerned, most of us need to do a lot
age of 5, [1] and gossip as other than they would if aware of their environment,
less projecting.
most researchers under- they both felt positively thus incubating the com-
If we can get a grip on our “techno-
stand it—talk between at about him or her. [5] plex higher functioning
ference,” as some psychologists have
least two people about Gossip may even that would ultimately yield
called it, we are likely to ind that we can
absent others—accounts make us better people. A such glories of civilization
do much more for our children simply for about two-thirds team of Dutch research- as the Talmud, Pascal, and
by doing less—regardless of the qual- of conversation. [2] In ers reported that hearing Ann Landers.
ity of their schooling and quite apart the 1980s, the journalist gossip about others made So the next time you’re
from the number of hours we devote to Blythe Holbrooke took a research subjects more tempted to dish the dirt,
them. Parents should give themselves stab at bringing rigor to reflective; positive gossip fear not—you may actually
permission to back of from the sufocat- the subject, tongue firmly inspired self-improvement be promoting cooperation,
ing pressure to be all things to all people. in cheek, by positing the eforts, and negative gos- boosting others’ self-
Put your kid in a playpen, already! Ditch Law of Inverse Accuracy: sip made people prouder esteem, and performing
that soccer-game appearance if you feel C = (TI)v – t, in which the of themselves. [6] In the essential task of the
like it. Your kid will be fine. But when likelihood of gossip being another study, the worse human family. That’s what I
you are with your child, put down your circulated (C) equals its participants felt upon heard, anyway.
damned phone.
THE STUDIES: and Social Adaptation” in Good Gossip Chemistry Through Negativity” (Personal Psychology, June 2004)
(University Press of Kansas, 1994) Relationships, June 2006) [8] Feinberg et al., “Gossip and Ostra-
Erika Christakis is the author of The [1] Engelmann et al., “Preschoolers [3] Blythe Holbrooke, Gossip (St. Mar- [6] Martinescu et al., “Tell Me the Gos- cism Promote Cooperation in Groups”
Afect Others’ Reputations Through tin’s, 1983) sip” (Personality and Social Psychology (Psychological Science, March 2014)
Importance of Being Little: What Young Prosocial Gossip” (British Journal of De- [4] Dunbar et al., “Human Conversational Bulletin, Dec. 2014) [9] Robin Dunbar, Grooming, Gossip,
velopmental Psychology, Sept. 2016) Behavior” (Human Nature, Sept. 1997) [7] Baumeister et al., “Gossip as and the Evolution of Language (Harvard
Children Really Need From Grownups. [2] Nicholas Emler, “Gossip, Reputation, [5] Bosson et al., “Interpersonal Cultural Learning” (Review of General University Press, 1998)

16 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C Illustration by CHRISTOPHER DELORENZO


D I S PAT C H E S

S HORTLY AF TER I MET


Lina Khan, her cellphone rang. The call
was from a representative of a national
organization, regarding a speech it had
asked her to give. Khan was courteous on
the phone, but she winced momentarily
after hanging up. “That was the Ameri-
can Bar Association,” she confessed. “I
don’t know if I’ve passed the bar yet.”
This feeling—that Khan’s ideas are in
high demand slightly before her time—
has characterized much of her life lately.
In the past year, the 29-year-old legal
scholar’s work has been cited approvingly
by the lefty, rabble-rousing congressman
Keith Ellison and by a Trump-appointed
assistant attorney general, Makan Delra-
him. She has been interviewed by NPR
and written op-eds for The New York Times.
She has done it neither by focusing on
a hot-button issue nor by cultivating a tele-
genic demeanor. She is just a young adult—
one of many, I would learn—interested in
an old topic: antitrust law, that musty cor-
ner of American jurisprudence aimed at
curtailing monopoly power.
For the past few decades of American
life, the specter of monopoly was gener-
• SKETCH ally raised only regarding companies
that seemed custom-designed to rip of
consumers—airlines, cable providers,

THE TRUSTBUSTER Big Pharma. These were businesses that


pulled from the long-standing monopo-
list’s bag of tricks: They seemed to keep
Lina Khan has a novel theory for how
prices artiicially high, or they formed an
monopolies work—and her sights are unspoken cartel with other industry titans.
set squarely on Amazon. Typically, consumers worried most about
how monopolies would pinch their wallet.
BY ROBINSON MEYER
For Khan and her colleagues at
the Open Markets Institute, an anti-
monopoly think tank based in Wash-
ington, D.C., monopoly power includes
all of that. But it goes further. Even
when monopolies appear to beneit con-
sumers by ofering free services or low

Illustration by TIM TOMKINSON T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 17


D I S PAT C H E S

prices, Khan contends that they can still publishing,” she told me. “Publishers used chicken-farming industry. Combing the
be deeply harmful. Among the group’s to be able to take risks with heavier books papers for corporate-consolidation news,
frequent targets are some of the most that might not be as popular, and they used she started seeing monopoly power in
popular companies in America: Google, to be able to subsidize them with best sell- everything. She realized that antitrust pol-
Facebook, and the one to which Khan ers.” But Amazon’s demand for discounts icy could dominate the decades to come
has committed much of her published has made it harder to cross-subsidize this and that she had to understand it better.
work, Amazon. She tells a comprehen- way, leading to consolidation among book So Khan took time of to go to law school—
sive story about how these companies publishers and reduced diversity. and began intensively studying Amazon.
make Americans less free, a story that This is a typically Khanian analysis. In Three years later, in January 2017,
recently received a surprising addendum: her telling, monopolies don’t just exploit she published the result of that study,
Last year, monopoly power cost Khan a consumers and workers in
month’s pay. their part of the economy.
Even when they ofer low
MET KHAN on a Friday morning last prices to consumers, their
I fall at the Shops at Columbus Circle,
a glitzy mall at the southwest corner of
influence propagates
through the entire system.
Amazon has grown so
large that it can undercut
Central Park that now contains not one If one part of an industry other companies just by
but two Amazon properties. On the third consolidates, then all the
loor is an Amazon Books, one of more other parts of the industry
announcing that it will
than a dozen brick-and-mortar book- will feel pressure to con- soon compete with them.
stores the company has opened since solidate too.
2015. It’s inspired less by libraries than Amazon does not, in
by Apple stores: paperbacks and Kindles some respects, look like
side by side on pale, sparse shelves. And a monopoly. According to the National “Amazon’s Antitrust Paradox,” in the Yale
in the basement is a sprawling Whole Retail Federation, it is only the country’s Law Journal. It went viral—or at least as
Foods—Amazon acquired the grocery seventh-biggest retailer by total sales. It viral as dense legal scholarship can go. Its
chain for $13.7 billion last year—its sells more than Target, but less than Wal- driving question is simple: How did Ama-
crowded aisles lined with craft beer, for- greens. And Walmart, the nation’s largest zon get so big?
eign yogurts, and kohlrabi. retailer, still generates nearly three times The answers are nearly as straight-
Khan is unassuming in person, with as much revenue as Amazon. forward. First, Khan says, Amazon has
a narrow face and unruly black hair. She Yet these numbers fail to capture Ama- been willing “to sustain losses and invest
arrived at Amazon Books wearing the zon’s online dominance. About 44 cents aggressively at the expense of profits.”
uniform of the young, urban professional of every dollar that Americans spend This isn’t a controversial assertion: Ama-
class: black jeans, an oversize green lan- online go to Amazon. (The next-biggest zon has posted an annual proit for only
nel shirt, a cycling-inspired backpack. online retailer, Ebay, gets about six cents 13 of the past 21 years, according to The
(Full disclosure: I was wearing almost of that dollar.) They also miss Ama- New York Times. Historically, it has plowed
exactly the same outit.) She arrived very zon’s prodigious growth. In 2010, when any proits right back into cheaper prices
slightly late and immediately apologized. Khan graduated from college, Amazon and R&D into everything from robotics
She might be a little slow, she said: She employed 33,700 people. It now employs to image recognition. Second, Amazon is
was getting married in a week, her entire more than 560,000, and its search for integrated vertically, across business lines.
family was in town, and it had already a site for its second headquarters has In addition to selling stuf online, Amazon
been a ludicrously busy month. But I turned cities and locales across the coun- now publishes books, extends credit, sells
couldn’t detect any sluggishness. A min- try into desperate supplicants. Three online ads, designs clothes, and produces
ute later, she was reeling of paragraph- years ago, Amazon was worth less than movies and TV shows. It is also one of the
length digressions on the history of Walmart. As of this year, it is three times world’s largest providers of cloud stor-
Amazon’s business and the nature of its as valuable as the big-box king. (Accord- age and computing power, renting server
monopoly power. ing to an Amazon spokesperson, “In every space to Netlix, Adobe, Airbnb, and NASA.
“There’s a whole line of critique about one of our businesses we have incredible These two practices—predatory pric-
Amazon that’s culture-based, about how competition. In worldwide retail, we’re ing and integration across business lines—
they’re wrecking the experience of book- less than 1 percent. We think our job is to may sound normal. But under old read-
stores,” Khan told me as we surveyed Neil keep inventing for customers.”) ings of U.S. antitrust law, they are illegal.
deGrasse Tyson’s latest tome. “I person- Khan didn’t start out interested in Still, it’s unclear whether consum-
ally am less focused on that element.” antitrust. Seeking a job at the New Amer- ers have seen higher prices as a result of
Instead, she argues that Amazon ica Foundation, a center-left think tank either strategy. As such, Amazon rejects
has denuded America’s book-buying in Washington, she landed in the group’s the “predatory pricing” label. And
landscape in other ways. “Amazon has antitrust program, whose director, Barry Republican Senator Orrin Hatch last
massively— and I’m trying not to use Lynn, gave her an ad hoc graduate edu- August decried the new antitrust move-
this particular word, but I can’t not use cation in the anti-monopoly movement. ment as “hipster antitrust” and said it left
it here—disrupted the business model in She studied the book industry, then the him “deeply unimpressed.”

18 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
• SKETCH

As Khan and I entered the sprawling profits into price discounts. Partly as a own shopping service above those of
Whole Foods three stories below Amazon result, Amazon has grown so large that its rivals in search results. The penalty:
Books, we noticed a tower of avocados. A it can undercut other companies just $2.7 billion.
sign bragged that, thanks to the Amazon by announcing that it will soon compete Barry Lynn’s team at New America,
merger, a single avocado now cost $1.49, with them. When Amazon purchased which by then was known as Open Mar-
down from $2.49. Khan cracked up. “This Whole Foods, its market cap rose by kets, was delighted. Khan helped edit
is peak myself,” she said. “This is hipster $15.6 billion—some $2 billion more than a short statement from the team, call-
antitrust, right here.” it paid for the chain. Meanwhile, the rest ing Google’s market power “one of the
of the grocery industry immediately lost most critical challenges for competition
ROM THE PROGRESSIVE ERA $37 billion in market value. (Amazon pro- policymakers in the world today.” They
F onward, the U.S. government
enacted a powerful set of antitrust laws to
tests that it has no control over how inves-
tors value its competitors.)
published it and moved on with their lives.
But a few hours later, Lynn excused
curb “the Curse of Bigness,” as Supreme When a company has such power, himself from a conference call that Khan
Court Justice Louis Brandeis put it. The Khan believes, it will almost inevitably was on. Anne-Marie Slaughter, New
scope of these laws was remarkable: The wield that power far and wide, distorting America’s president, was on the other line.
Court once used them to block a shoe not just the market itself, but the whole According to The New York Times, Eric
company from acquiring 2 percent of the of American life. With suicient power, Schmidt, Google’s executive chairman at
national footwear market. companies can commission studies, the time, had seen the statement and was
But antitrust laws could be unwieldy. rewrite regulations, bulldoze neighbor- unhappy about it. Schmidt had previously
Judges sometimes struggled to know hoods, and impoverish education and been the chairman of New America, and
whether they were enforcing the law or welfare systems by securing billions in he and Google had given millions to the
capriciously blocking a merger. And then, sweetheart tax cuts. When a company foundation over the years. A conference
in 1978, a Yale Law professor named Rob- comes to monopolize a market—when room at New America is called the Eric
ert Bork promoted a clean new theory of it grows so big that it can threaten other Schmidt Ideas Lab.
antitrust law, inspired by the libertarian industries just by entering them—it A few days later, Slaughter emailed
Chicago school of economics. ceases to be merely a company. It Lynn to inform him that the foundation
Bork decreed that all antitrust suits becomes an institution so powerful that would be spinning of his group, but with
should be judged by one question: What it can rule over people like a government. full funding and staing. “The time has
will most lower prices for consumers? “That was the insight of Brandeis,” come for Open Markets and New Amer-
The answer, he said, was almost always Khan told me. “For most people, their ica to part ways,” she wrote. New Amer-
more mergers. When companies merge, everyday interaction with power is not ica disputes many of the details of The
they get rid of redundant business units, with their representative in Congress, Times’ account, primarily the notion that
lower their operating costs, and become but with their boss. And if in your day-to- “Google lobbied New America to expel
more efficient, ultimately passing this day life you’re treated like a serf in your the Open Markets program.” Google also
eiciency on to consumers as lower prices. economic relationships, what does that denied playing any role in New America’s
Within a decade, the Reagan admin- mean for your civic capabilities—for your decision to cut ties or ever threatening
istration turned Bork’s theory into oicial experience of democracy?” to cut of funding. Slaughter described
Department of Justice policy. The busi- Khan sees the new antitrust move- problems with the group’s institutional it.
ness world noticed. In 1985, there were ment, above all, as a revival. Well before However, after two months, negotiations
about 2,300 corporate mergers in the Brandeis’s day, Thomas Jeferson sought on the spin-of failed and the two think
United States, according to the Institute to add an anti-monopoly clause to the tanks formally separated.
for Mergers, Acquisitions and Alliances. Constitution. Andrew Jackson said For Khan, the issue was more than
In 2017, there were more than 15,300, a Americans should “take a stand against academic: It cost her a month of pay.
new record. all new grants of monopolies.” And She’d been due to be hired back at New
Bork’s views become interesting in some legal scholars even see an anti- America in late July, following her com-
light of Amazon. Bork thought vertical monopoly instinct in the Fourteenth pletion of the bar exam. But that plan was
integration was ine: Since he believed Amendment’s equal-protection clause, put on hold, so Khan worked without pay
markets were perfectly efficient, he since monopolies can assert claims to until late August, when Open Markets
assumed that a lower-cost competitor special protections of the law. “If Amer- established itself as a new and indepen-
would always butt in and ight of a would- ican democracy was founded on this dent think tank and rehired her.
be monopolist. And predatory pricing? It set of ideas and traditions,” Khan said, It was an unexpectedly real example—
is “a phenomenon that probably does not “then we just took a knife and lopped of and one that hit close to home—of how
exist,” he wrote. The Chicago school, he one half of it. It’s just gone.” a single powerful irm can inluence the
said, had proved that companies would Khan knows firsthand what this many organizations in its orbit. As Khan
always pursue short-term profits over can look like. In June 2017, the Euro- noted, not without irony: “It was a proof
long-term growth. pean Union slapped Google with the of concept of our work.”
Amazon’s history seems to belie this largest-ever fine of its kind. Officials
claim. For more than a decade, Wall alleged that the search giant violated Robinson Meyer is a staf writer at
Street allowed the company to plow any anticompetition law when it ranked its The Atlantic.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 19
D I S PAT C H E S

an apparent alternative to Pilates; and,


innumerable times, people deposited
bags of dog poop into lawn-clipping and
recycling canisters at the curb. All of this
news came courtesy of the social-media
service Nextdoor. On its website and
app, people can post recommendations,
updates, and warnings about their build-
ing, block, or neighborhood.
Anyone who has subscribed to a
neighborhood email listserv—or used the
internet—can guess what might go wrong.
Social networks connect people, but
many of those connections degrade into
vitriol. If Twitter is where you ight with
strangers, and Facebook is where you vie
with friends, then Nextdoor is where you
get annoyed with neighbors—for send-
ing “urgent alerts,” pushed late at night
to mobile phones, about questionable
emergencies; for trying to sell a tattered
massage table or used carpet shampooer
at near-retail price; for issuing nasty repri-
sals on matters large and small. But it can
also foster connections among neigh-
bors and help counter the social isolation
brought about by technology.
Nextdoor works a lot like Facebook,
but instead of a “Like” button, it ofers
a “Thank” button, encouraging a kind
of neighborly grace. More important, in
order to join, you have to prove that you
live where you say you do (by entering a
code mailed to your home address, for
• TECHNOLOGY
example). Which means the community
you enter is not imagined or diasporic,

THESE ARE THE PEOPLE comprising people from the same school,
profession, or interest group—it’s physical.
You can “mute” neighbors on Nextdoor

IN YOUR NEIGHBORHOOD to hide their posts, but you can’t make


them move away. Like it or not, these are
the people in your neighborhood—the
Nextdoor, a hyperlocal social-media platform,
people that you meet each day, as the old
highlights petty grievances—and proves that Americans Sesame Street song goes. Not just the post-
have more in common than they think. man and the barber, but also the aspiring
belly dancer, the night clipper, the cat
BY IAN BOGOST
looser, and all the rest.
Thanks to its popularity, the service
offers a unique window into daily life
around the country. Nextdoor’s virtual
communities—which cover more than
E R E A R E S OM E O F T H E T H I NG S I heard about in my 180,000 U.S. neighborhoods, including
neighborhood over the past year: A thunderstorm downed more than 90 percent of those in the 25
a tree, blocking a central road; a shadowy agent called “the largest cities—are becoming representa-
night clipper” arose, surreptitiously cutting overhanging tive of the country’s actual populations.
bushes while unsuspecting property owners slept; several What do Nextdoor users talk about?
dogs and cats were lost, found, or “on the loose,” whatever On April 18, 2018, to pick a random day,
that means for a cat; a federal-grand-jury-summons tele- the nation mourned former First Lady
phone scam struck; someone sought belly-dancing classes, Barbara Bush, Japanese Prime Minister

20 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Illustration by JOSH COCHRAN
Shinzo Abe visited Donald Trump to dis- (When her Twitter following recently Bowling Alone, about the decline of in-
cuss North Korea, and the world reacted surpassed that of Nextdoor’s corporate person social discourse in America and
to a deadly accident aboard a Southwest account, the company’s head of commu- its consequences for civic life. Putnam
Airlines light. But on Nextdoor, the over- nity congratulated her, while also gen- criticized the technological individualism
whelming majority of Americans were tly wondering whether she would blur encouraged by television and the inter-
focused on the impacts of late-season the neighborhood names in her posted net, which had already shown a capacity
snowstorms: stuck cars, downed power screenshots.) Less than a year after to promote selfishness. Wymer argued
lines, and especially snowplows. Grout launching the accounts as a loving gag, that Nextdoor cuts against that trend:
and kittens were on mountain-time Takahashi has built what might amount to The company boasts dramatic examples
minds, and Oregonians seemed to be the most complete contemporary picture of new collaborations the service helped
enduring a spate of lost wallets and duck of day-to-day American behavior, a kind enable—the neighbor who donated an
encounters. In Florida and Colorado, of crowdsourced Kinsey report on munici- organ to someone 10 doors down, whom
problems with telecom services domi- pal perversity.
nated the conversation. Takahashi echoes Wymer
This is pretty normal. Steve Wymer, on noise complaints—talk of
Nextdoor’s vice president of policy, told ireworks or gunshots (they One user donated an
me that the same topics arise again are rarely actual gunshots)
and again, modulated by region and is common, she says. Some-
organ to someone
neighborhood type. Service requests and times these complaints have 10 doors down, whom she
recommendations constitute 30 percent dramatic consequences. In met through Nextdoor.
of chatter, and discussions of real estate Seattle, a post about a dog’s
make up another 20 percent. About bad reaction to some kind
10 percent of Nextdoor conversations of cannon that was sounded
relate to crime and safety, Wymer said. during Seahawks football games led to she wouldn’t have known were it not for
(Suspicious persons come up a lot, often an online dispute, and a neighborhood Nextdoor, and the person stranded on a
amounting to sightings of people of color meeting at a library to talk it out erupted roof by Hurricane Harvey who was able to
in predominantly white areas. Nextdoor into a brawl. “Seattle is like the Florida summon a rescue boat via the service.
has attempted to discourage posts that of Nextdoor,” Takahashi told me, refer- But usually life is less dramatic than
use appearance as a proxy for criminality ring to the Sunshine State’s tendency to that. In the most-common Best of Next-
by prompting users to add more detail surface all manner of improbable events. door submissions, neighbors worry about
and blocking some posts that mention Los Angeles is another source of good a weird truck driving by slowly, early in
race.) Public agencies such as police and material: She’s received a handful of sub- the morning. Ever vigilant, other users
emergency-management departments missions about unrest in parts of the city respond that they have already reported
also post updates to their constituencies. where YouTube stars live, as fans mob the the suspicious vehicle to police, as law-
Noise complaints are another popular streets trying to catch a glimpse. enforcement representatives on the ser-
subject, according to Wymer—ireworks Best of Nextdoor reveals a charming vice encourage. Typically, the ofending
seem to raise particular ire—as are clas- cluelessness that pervades America’s vehicle turns out to be the newspaper-
siieds, missing pets, and gardening tips. communities. People in cities can’t seem delivery person, plodding through the
Judging by the conversations on to tell the diference between a possum suburbs to bring print news to the resi-
Nextdoor, it would seem that Americans and a house cat, for example. In Alabama, dents who still read it that way. Eventu-
are concerned irst about the safety and someone tried to sell an unopened box ally, someone explains how newspaper
security of their property, family, and of Hot Pockets. Near St. Louis, one resi- delivery works, and order is restored.
pets, and then with their property’s, fam- dent asked why the neighborhood of I’ve seen a version of this post in my
ily’s, and pets’ upkeep and improvement. WingHaven is called “Swinghaven.” In own neighborhood. Someone writes:
Though the platform breeds its share a suburb of San Diego, someone posted “Concerns about white man with turban
of conlict, it is notable—in contrast to an image of a found sex toy and—not on bicycle.” Almost instantly, responses
other social networks—for the com- comprehending the purpose of the arrive: “Oh, that’s Floyd, he’s harmless,”
monality it reveals, even in these times device—worried that it “looks valuable.” and “Yeah, he’s been around forever.”
of unprecedented political division. No But most of Takahashi’s collection cata- Some neighbors theorize that he might
one, Democrat or Republican, wants a logs more-mundane patterns, like the be a wizard. It’s a small thing, and maybe
neighborhood strewed with dog poop. poop-in-the-trash-bin crisis that seems not one to be proud of—but the neigh-
to plague all Americans. Takahashi has bors’ concerns get assuaged, and Floyd
ENN TAKAHA SHI OPERATE S amassed countless specimens, as it were, escapes torment. That’s a post worth
J a Twitter account and Facebook
page called Best of Nextdoor. Because
from run-of-the-mill lamentations to
complex home- surveillance-camera-
clicking “Thank” on.

Nextdoor posts are private to local com- facilitated stakeouts conducted to ind Ian Bogost is a contributing editor at
munities, Takahashi relies on users to and shame the ofending dog walker. The Atlantic and the Ivan Allen College
submit funny or weird things they see in In our conversation, Steve Wymer Distinguished Chair in Media Studies at
neighborhood groups across the country. brought up Robert Putnam’s 2000 book, the Georgia Institute of Technology.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 21
D I S PAT C H E S

innovate. By 2007, according to Bloom-


berg, interest expense consumed 97 per-
cent of the company’s operating profit.
• BUSINESS It had few resources left to upgrade its
stores in order to compete with Target, or
to spif up its website in order to contend
YOU BUY IT, YOU BREAK IT with Amazon. “It’s true that they couldn’t
respond to Amazon,” Eileen Appelbaum,
How private equity is killing retail a co-director of the Center for Economic
and Policy Research, told me. “But you
B Y B RYC E C OV E R T have to ask yourself why.”
Shortly after the buyout, the com-
pany’s CEO implemented a plan to
combine and remodel Toys “R” Us and
Babies “R” Us locations. Customers liked
A N N M A R I E R E I N H A R T was one of placed around the company’s neck. Toys the changes, but the company was able to
the irst people to learn that Toys “R” Us “R” Us had a debt load of $1.86 billion revamp only 146 of its more than 1,500
was shuttering her store. She was super- before it was bought out. Immediately stores by 2010. By that point, it was facing
vising the closing shift at the Babies “R” after the deal, it shouldered more than the efects of the Great Recession. Most
Us in Durham, North Carolina, when her $5 billion in debt. And though sales had retail operations try to keep their debt
manager gave her the news. “I was almost slumped before the deal, they held rela- burden low to be ready for an inevitable
speechless,” she told me recently. Twenty- tively steady after it, even when the Great downturn; when you sell a product as
nine years ago, Reinhart was a new mother Recession hit. The company generated discretionary as toys, a recession can hit
buying diapers in a Toys “R” Us when she $11.2 billion in sales in the 12 months particularly hard. Thomas Paulson, the
saw a NOW HIRING sign. She applied and before the deal; in the 12 months before founder of the investment irm Inlection
was ofered a job on the spot. She eventu- November 2017, it generated $11.1 billion. Capital Management, which focuses on
ally became a human-resources manager Saddled with its new debt, how- companies that serve consumers, told me
and then a store supervisor. ever, Toys “R” Us had less lexibility to that when the retail landscape shifts, a
She stayed because the company
treated her well, accommodating her
schedule. She got good benefits: health
insurance, a 401(k). But she noticed a
diference after the private-equity irms
Bain Capital and Kohlberg Kravis Roberts,
along with the real-estate irm Vornado
Realty Trust, took over Toys “R” Us in 2005.
“It changed the dynamic of how the store
ran,” she said. The company eliminated
positions, loading responsibilities onto
other workers. Schedules became unpre-
dictable. Employees had to pay more for
fewer beneits, Reinhart recalled. (Bain
and KKR declined to comment; Vornado
did not respond to requests for comment.)
Reinhart’s store closed for good on
April 3. She was granted no severance—like
the more than 30,000 other employees
who are losing their job with the company.
In March, Toys “R” Us announced
that it was liquidating all of its U.S. stores
as part of its bankruptcy process, which
began last September. Observers pointed
to the company’s struggle to ight of new
competition. In its court iling, the com-
pany laid the blame at the feet of Amazon,
Walmart, and Target, saying it “could not
compete” when they priced toys so low.
Less attention was paid to the alba-
tross that Bain, KKR, and Vornado had

22 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C Illustration by REBEKKA DUNLAP


company may need to make investments the company, by either helping it go pub- Private equity can stack the deck in
and even adapt its business model to stay lic or selling it. other ways, too. Firms can direct busi-
aloat. If it’s already carrying signiicant In some instances, private-equity irms nesses they own to buy other companies
debt, it’s “really handcuffed,” he said. lend know-how that allows a company and then act as broker on the deals, reap-
“That’s what happened with Toys “R” Us.” to operate more efficiently or expand ing transaction fees. After its buyout, Toys
Josh Kosman, the author of The Buyout beyond a small niche. “There’s a role for “R” Us acquired a number of companies,
of America, agrees: “All it takes is for earn- private equity in certain industries that are including FAO Schwarz, eToys.com, and
ings to stop rising and level of, or even experiencing disruption,” Angela Kapp, assets from KB Toys (itself a failed recla-
decline a little bit, and you’re in a whole an investor who sits on the boards of mation project of Bain’s). Consolidating
heap of trouble.” private- equity- owned
Toys “R” Us is hardly the only retail companies, told me. One
operation to learn this lesson the hard way. of the more celebrated
The so-called retail apocalypse felled retail buyouts was KKR’s
roughly 7,000 stores and eliminated more acquisition of Dollar Gen-
Two-thirds of the retailers
than 50,000 jobs in 2017. For the spate of eral, in 2007. After bring- that filed for Chapter 11
brands that have recently declared bank- ing in a new management in 2016 and 2017 were
ruptcy, their demise is as much a story team that made changes backed by private equity.
about private equity’s avarice as it is about such as upgrading the qual-
Amazon’s acumen. ity of the company’s prod-
In April 2017, an analysis by Newsday ucts and tailoring them to
found that of the 43 large retail or super- its customer base, the irm
market companies that had iled for bank- helped it go public. It now has the most brick-and-mortar and online toy busi-
ruptcy since the start of 2015, more than stores of any U.S. retail chain. Firms “bring nesses may have been a good-faith strat-
40 percent were owned by private-equity resources and capabilities and [have] seen egy. What’s certain is that the deals helped
firms. Since that analysis, a number of the movie before,” Kapp said. generate $128 million in transaction fees
others have joined the list, including Nine But that doesn’t mean the movie for the owners.
West, Claire’s, and Gymboree. An analy- always has a happy ending. “I don’t even
sis by the irm FTI Consulting found that know if there are that many success cases O FAR , PRIVATE E QU I T Y ’S string
two-thirds of the retailers that iled for
Chapter 11 in 2016 and 2017 were backed
in retail,” Sucharita Kodali, an analyst at
the market-research company Forrester,
Sof failures in retail hasn’t caught up
with it. Pension funds and institutional
by private equity. told me. She allowed that Toys “R” Us was investors keep coming back to the promise
“Had these companies remained pub- hardly in great shape before its acquisi- of a 12 percent (or greater) return on invest-
licly owned,” Paulson said, “they would tion, but says the buyout only made things ment, well above what’s ofered by bonds
have had a much higher probability of worse. “I think it probably hastened their or even public companies. But creditors
being able to adapt, to invest, and to with- death,” she said. Even Dollar General’s and vendors left holding the bag when
stand” the ups and downs of the economy. success, she argued, had a lot to do with retailers go out of business don’t have
timing and the particular corner of retail it much recourse.
P R I VAT E - E Q U I T Y TA K E O V E R occupies—the recession pushed consum- One success story: Private-equity
A is akin to a family’s buying a house:
A irm contributes what is essentially a
ers toward its discount stores.
Given private equity’s poor track record
irms helped buy out the retailer Mervyn’s
in 2004, loading it up with $800 million
down payment using its own funds and in retail, it can be diicult to see what com- in debt and spinning off its real-estate
then inances the rest with debt. But in panies like Toys “R” Us hope to get from holdings. The company went bankrupt in
the case of a buyout, the firm doesn’t a buyout. For private equity, however, the 2008 and liquidated its stores, yet accord-
have to pay back the mortgage; instead, appeal is clear: The deals are virtually all ing to bankruptcy-court ilings, its owners
the company it bought assumes the debt. upside, and carry minimal risk. Many pocketed $200 million in fees and divi-
Private-equity firms enjoy the mis- private-equity irms chip in only about 1 to dends from 2004 to 2006. Vendors such
perception that they swoop in and save 2 percent of the equity needed for a lever- as Levi Strauss, which had sold clothes to
struggling companies from the verge aged buyout, and skim fees and interest the retailer and wanted to be paid for its
of ruin. They’ve long held the promise throughout the deal. If things go well, the goods, sued the private-equity owners.
of beneiting these companies through irms take a huge cut of the proit when They secured a $166 million settlement,
close monitoring—and debt, the theory they exit. If everything blows up, they usu- arguing that the owners had played a role
goes, should impose discipline on mana- ally still escape with nary a burn. Toys “R” in driving Mervyn’s into bankruptcy. (The
gers. That’s the model followed by a few Us was still paying interest on loans it got owners did not admit any wrongdoing.)
specialty irms, but it is far more common from KKR and Bain up until 2016, as well In other countries where private equity
for private-equity firms to seek moder- as millions a year in “advisory fees” for has a meaningful presence in the market,
ately successful targets where they see unspecified services rendered. Accord- it operates with more restrictions. Ger-
an opportunity to increase proit margins. ing to one estimate, the money KKR and many and Denmark guarantee that most
After a few years of slimming costs and Bain partners earned from those fees more workers receive severance, making it far
boosting revenues, the goal is to of-load than covered the irms’ losses in the deal. costlier for a private-equity irm to seek

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 23
are part of a burgeoning
D I S PAT C H E S
efort to redefine Japanese
fatherhood. An organiza-
tion called Fathering Japan
layofs to increase proit margins. In the
was started in 2006, for
U.S., labor campaigns have successfully
example, to help fathers be
pushed a number of retailers to pay more,
more involved; it provides
offer better benefits, and improve their courses, and a sense of
scheduling practices. But the sector’s community. Yet men who
instability is throwing these gains into forgo work to care for their
question, and some reformers would kids remain outliers.
like to see even more radical change. Back at our Ikumen
A conglomeration of workers’-rights class, the instructor
and financial- reform organizations is lectures about Japan’s
seeking to outlaw leveraged buyouts demographic crisis, the
altogether. “They weren’t always legal,” social consequences of
• B I G I N   . . . JA PA N
Charles Khan of the Strong Economy for the declining birth rate,
All Coalition, which is part of the group, and why men should con-
points out. Before the 1980s, companies Dad Classes for sider child care a national
couldn’t finance deals with such high
levels of debt. One aim of Khan and his
the Single Guy duty. Everybody nods
along. But besides trying
allies is to once again force buyouts to Making men more marriageable, on a pregnancy suit, what
rely on a smaller portion of debt. “The one cumbersome pregnancy suit at a time can men do to help?
economy has existed long before pri- For starters, the
vate equity,” he says. “I think it can exist BY STEPHEN MARCHE teacher recommends,
without private equity.” compliment your wife.
Political solutions, even more-modest Instead of saying things
ones, could be a tough sell in Congress. like “Why did you sleep in

T
 
Private-equity firms shower a lot of HE MAN in the Ikumen is a portman- so late?,” men could ofer
money on Republicans and Democrats traditional kimono teau of the Japanese word words of praise: “This is
alike. They’ve also made the most of the is having dificulty ikuji—meaning “child- delicious.” “Your hair is set
revolving door between the public and the with the breasts. The rearing”—and the English nice.” “Your outfit looks
private sectors: Barack Obama’s Treasury weight of the belly strains word men. Though the cute today!”
secretary Tim Geithner is now the presi- his back. Simply walking term has been around After the lecture, we
dent of the private-equity irm Warburg around the room—a party for years, the divide learn how to bathe an
Pincus; Donald Trump’s commerce sec- room in a Tokyo condo between work and home infant. (I nearly fail the
retary, Wilbur Ross, founded a private- building—is more like in Japan remains nearly lesson, even though I’ve
equity irm in 2000. lumbering. Lying down absolute. Mothers still helped raise two babies
While their demands may prove overly and getting up again is a tend to shoulder almost all and kept them both pretty
struggle. The rest of the domestic responsibilities— damn clean.) Though
ambitious, reformers are clear-eyed about
men in the Ikumen class an imbalance that can the skills being taught
what will happen without a change of
laugh as he tries to adjust be miserable, as Masako are basic, I can’t help but
some kind. Retail companies face billions
to the new reality. But then Ishii-Kuntz, a sociology admire the students for
of dollars in debt coming due in the next
we all have to try on the professor, hears wherever trying to train themselves,
ive years, much of it thanks to leveraged
pregnancy suit ourselves, she goes. “I just gave a in advance, to take care
buyouts. More bankruptcies are on the way.
and one by one, we come talk this morning, and my of a child. Something has
Toys “R” Us workers are making the
to the same conclusion: It’s audience [was] all younger to give in Japan. You can’t
case for severance pay directly to law-
hard to be a woman. mothers,” she told me in promote gender equality
makers. In early May, Ann Marie Reinhart The class is sort of her ofice at Ochanomizu in the workforce and raise
and other former employees met with like the prenatal ones I University. “Many of them the birth rate without
Senator Bernie Sanders and Representa- attended when my wife were talking about ‘Oh, doing something just as
tive Keith Ellison. Next, they’ll take their was pregnant—except that my husband is just simply revolutionary: transforming
demands to KKR, Bain, and Vornado. none of my classmates is not interested in house- society’s attitudes toward
“We’ve given blood, sweat, and tears to this actually a father or father- work or child care.’ That’s men, specifically fathers.
company,” Reinhart told me. “So to walk to-be. Some of them aren’t not rare at all.” Bringing women into
away with nothing, it’s just humiliating.” even dating. Many of them Needless to say, this the workplace is one
In the meantime, Reinhart is looking will list their attendance in state of afairs has not thing; bringing men fully
for work. She hopes she won’t have to this class on their dating helped either women’s into the household will be
take another job in retail. “I could not go profiles with the aim of success in the workforce quite another.
through this again,” she said. attracting a partner. The or the country’s critically
young women they’re low birth rate, two major Stephen Marche’s new
Bryce Covert is a contributing op-ed hoping to interest want sources of economic drag. podcast, How Not to Fuck
writer at The New York Times and a to see some fatherhood Which is where Ikumen Up Your Kids Too Bad, is
contributing writer at The Nation. credentials up front. classes come in. They available on Audible.

24 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C Illustration by RAMI NIEMI


T H E

C U L T U R E
F I L E
B O O K S , A R T S , A N D E N T E R TA I N M E N T

THE OMNIVORE

The Wisdom of
Russell Brand
The recovering addict, comedian,
movie star, and former spouse of Katy
Perry has entered a new phase: as the
host of a brainy, philosophical podcast. (Brand, in this scene, is addressing a group of wonder-struck English school-
BY JAMES PARKER children.) “To feel adored is a buzz for me, but—what does it matter, really?”
Russell Brand has always been interesting. Excessively interesting, per-
haps: There’s an outsize, overheating quality to his charisma, as if it entered
his body superpower-style, via a laboratory accident or lying asteroid chunk.
Forty-three years old, he comes from the working-class backwater of Grays,
Essex, in England. His physical presence is slightly dazzling, unnerving, with
a subversive, greased-by-eroticism efect. The word louche attaches itself to

W
HEN YOU’VE DONE him. Genetically a comedian, he is also an occasional ilm star. As the sleazily
it all, what then? When marvelous rock-god boyfriend Aldous Snow in Forgetting Sarah Marshall, he
SHUTTERSTOCK; ADOBE STOCK; WIKIMEDIA; FLICKR
you’ve smoked all the stole so many scenes that he got his own spin-of movie, Get Him to the Greek.
crack, eaten all the He is also some sort of culture-jammer, a serial causer of lutters/disturbances
chocolate, had all the in television studios and at awards ceremonies. (“Is this what you all do for a
sex, made all the money, living?” he asked during an infamous 2013 takeover of Morning Joe, a phero-
and been on all the talk shows—where do you go monal blitz that deprived the panel of speech and left Mika Brzezinski slurping
next? Because there it is, squatting on the far side of in panic from her water bottle.) In pre-Brexit Britain he reaped the scorn of
adulation: nothingness. “Celebrities,” the Buddhist the political classes by appearing on current-afairs programs, long-haired and
scholar Robert Thurman once said, “are in a very messianically tinged, and preaching revolution: transformation of conscious-
interesting position. They’ve already achieved ness, down with capitalism … love. He writes, speaks, and performs a lot about
great fame, success, and wealth, and they’ve real- his former addictions—to drugs, to sex—and about his need for attention. For
ized that those things alone don’t bring happiness; less than two years, he was married to the pop diva Katy Perry.
that, in fact, they can be a real pain in the neck.” Or, But it is in his latest incarnation—as a podcaster, of all things, clamped in
as Russell Brand puts it, tunneling toward enlight- headphones and nuzzling a huge mic—that Brand has become genuinely,
enment in the 2015 documentary Brand: A Second slow-growingly, deep-brain interesting. The Brand who presents Under the Skin
Coming, “Fame and power and money is bullshit.” With Russell Brand, the second season of which began in June, is part seeker and

26 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C I l l u s t r a t i o n b y R YA N O L B R Y S H
2
billion
people
around the world have access to quality
medicines, dietary supplements and food
as a result of our standards, advocacy
and education.

The foundation of quality we build helps:

• Scientists keep discovering


• Manufacturers keep producing
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Find out how we’re


empowering a healthy
tomorrow: usp.com/tomorrow
part clown, capering at the margins of thought in snicker-snack of addiction is inside consumerism,
THE OMNIVORE
the company of scientists, anarchists, theologians, and inside the version of human relations that is
philosophers, psychologists, Marxist scholars, doc- determined by consumerism. And the ungratiied
umentarians, and mad professors. And Al Gore. celebrity, he for whom the world’s ultimate blow
“Thank you so much for doing this interview and job has not suiced, is our paradigm. The sensual
for putting so much thought into it, Russell,” the realm has combusted before his eyes, in demon
former vice president says, with hilarious imper- twists of chemical vapor. He has squandered his
turbability, to the gasping, insatiable person on the serotonin supply, his natural gladness endowment,
other side of the studio table. He will later reward and hungry ghosts are roosting in his blackened
Brand with some bass-boosted vice-presidential brain-wires. Time for a change of approach.
chuckles and, at the end of a frantic exchange about “We are diferent men, you and I,” Brand tells
climate change and spiritual renewal, exclaim, Andy Puddicombe, a co-founder and the mesmer-
“That is entertainment!” izingly everyday-English voice of the meditation
To the author and interrogator of capital- app Headspace. “I am a person that has found
ism Naomi Klein, Brand reveals that he read flesh very, very appealing and corrupting. I’ve
her book No Logo while in Cuba, addicted to found drugs very, very engaging. I like senses, I
heroin and making a commercial: “I felt some- like sensuality, I like the body. So I’ve had to come
what conlicted … I was making a chewing-gum to meditation, yoga, spirituality with a gun to my
commercial—the most vacuous of all products, head.” (Puddicombe gently points out that he too
of course, unnecessary mimicking of mastication has a body, of which he is quite fond.)
while the world starves.” “Bringing capitalism On his podcast, Brand is in dialogue with some
to Cuba, personally?” an amused Klein replies. very expert people, some very large and poised intel-
With the physicist and broadcaster Brian Cox he lects. And in dialogue, his efervescing synapses and
has a lyrical exchange of views on the meaning of manic facility with language—the tools of his trade
life, Cox contending that meaning is “local and
There’s an as a comedian—are stabilized and counterbalanced.
temporary”—supplied by us, in other words, and outsize, Not always, of course. Brand will prattle, yap, cross-
not by God—and Brand rather grandly demurring. overheating talk, overuse the word ideology, and now and
“What does it mean to you,” Cox asks, “what do quality to his again spiral of into monologue, into a heightened,
you feel like, if I say that there will come a time in incantatory speech that sounds weirdly lubricious:
the future when there is no consciousness in the
charisma, as New Age dirty talk. “My consciousness has existed
universe? So all possibility of meaning has gone, if it entered before me, and my consciousness will exist after
but the universe will still be there?” Brand barely his body via me,” he says to, or at, the biologist Rupert Sheldrake.
draws breath before responding: “I would say that a laboratory “My consciousness is part of a vital energy, a contin-
within my philosophy, consciousness and matter ual pranic low existing through all forms, existing
have the reverse relationship to in yours. I believe
experiment beyond and through time and space, time and space
that matter emerges from consciousness, not vice or flying aster- themselves being just referential points from this
versa. So even where the astrophysical context al- oid chunk. biological organism …” But by and large his pranic
ters and evolves, as brilliant men such as yourself low is contained: He listens, he pays attention, and
and your predecessors have demonstrated that will the conversations prickle brilliantly along.
happen, that to me is essentially irrelevant because Your enjoyment of Under the Skin will depend
it’s just part of the cosmic ballet continuing within on your tolerance for Russell Brand—how much
the framework of consciousness.” By way of proof, of him you can take before you’re overloaded. But
he cites Herman Melville, and then the comedian in this medium you might be able to take more
T H E C U LT U R E F I L E I C O N S B Y N E I G H B O R H O O D ST U D I O
Bill Hicks. Not bad. of him than you’d previously thought. The new
season promises conversations with Gabor Maté,
T IS BRAND’S presentation of himself as an the physician and addiction expert who wrote,

I addict, a man in recovery, a 21st-century con-


sciousness who has gone through the veil of
maya and now wants answers— or better questions,
“Addiction loods in where self-knowledge—and
therefore divine knowledge—are missing,” and
Jim Carrey. (Jim Carrey! There’s a guy who’s gone
at least—that provides the theme for what might of and come out on the other side of … something.)
otherwise be a scattershot sequence of encounters. And Brand will preen and prance and shake his
“I used to like nice, numb drugs,” he says wistfully bells, proclaiming the void within him, which is the
to the meditation teacher Sharon Salzberg, a nota- void within us all. “That there is information avail-
bly down-to-earth presence from whom, over the able,” he says to Sheldrake, “that can’t be under-
course of the interview, he elicits a lovely selec- stood within the existing template—it seems to me
tion of gurgling belly laughs and high, wild titters. bloody obvious.” So ask not whether Russell Brand
Aren’t we all addicts anyway, twitching over our is for real. Ask yourself, rather: Am I for real?
phone, infatuated by this, attached to that, buzz-
ing or starving for a little squirt of dopamine? The James Parker is a contributing editor at The Atlantic.

28 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Seven Ways of Looking at
Pointless Suffering

The Ashtray

This Radical Land

Fishing Lessons

Is the Cemetery Dead?

Sleep Demons

The University of Chicago Press www.press.uchicago.edu


angry men loom large in the genre’s history, it’s not
because they have tapped into some elemental well
of gender-speciic sentiment. Instead, they have
often made their mark by expanding the boundar-
ies of what anger or sadness, or anger and sadness
together, can sound like for guys.
Bono’s comment got me thinking not just about
that lineage of sound and sentiment, but about
Chester Bennington, the Linkin Park singer whose
suicide a year ago this summer I’ve had very much
in mind. By some measures the last top dog that rock
ever bred, the California group is often spoken of as
an embarrassing artifact of George W. Bush–era
cultural crudeness. But in hindsight, Linkin Park’s
trajectory, and Bennington’s, sheds light on an
evolving quest for new ways to express vulnerability.
The pop landscape that has emerged may bewilder
Bono, but space has opened up for male fury in more
malleable forms than ever—and such fury seems to
be, for better and for worse, in plentiful supply.
Linkin Park’s product was male rage in a form
the entire family could mosh to. (It’s worth not-
ing that sales igures for the band’s 2000 debut
album, Hybrid Theory, have been surpassed in
the new millennium by no rock album other than
The Beatles’ 1.) The guitarist Brad Delson’s cleanly
rumbling chords triggered the kind of shiver you
might feel while in a dinghy passing an aircraft car-
rier. Co–front man Mike Shinoda rapped in blocky
syllables, his voice a stentorian simpliication of
the voice cultivated by Public Enemy’s Chuck D.
A DJ who went by the name Mr. Hahn threaded in
nerdy-cool electronic sounds; the drummer, Rob
Bourdon, hammered with comforting steadiness;
MUSIC and a bassist who called himself Phoenix shel-
lacked on an ominous tint.
The Sound of Rage The most important ingredient was Benning-

and Sadness ton’s wail and whisper, a volatile fuel to be pro-


cessed by the others. To revisit the video for the
2001 Linkin Park single “Crawling” is to see his
powers at full strength, and his special appeal laid
The still-unfolding history of male angst in pop music bare. At the outset, a music-box ballerina spins, a
woman cries into a bathroom sink, a pretty key-
BY SPENCER KORNHABER
board melody plays, and Bennington screams. The
crying woman appears to be in an abusive relation-
ship, and the scrawny singer, his hair in peroxide-
blond spikes, seems to narrate her emotions. His
chorus—“crawling in my skin / these wounds, they

A
T THE END OF 2017, U2’s Bono made one of his periodic will not heal”—is a strained roar, truly volcanic. His
pronouncements about the state of rock and roll. “I think verses are soft and mannered. “Against my will, I
music has gotten very girly,” he told Rolling Stone. “There are stand beside my own relection,” Bennington sings,
some good things about that, but hip-hop is the only place for looking into the woman’s face. Her nose is pierced,
young male anger at the moment—and that’s not good … In as is his lip.
the end, what is rock & roll? Rage is at the heart of it.” He was Professional critics found such works mawk-
airing the sort of conventional wisdom you most commonly hear ranted from ish, and heavy-metal purists dissed Linkin Park
a barstool: Rock and roll is rooted in virility, and the genre’s decline in popu- in crasser terms—gay or, yes, girly. That’s because,
larity represents a worrisome triumph of the feminine. Though such gender for all its testosterone rage, the band violated the
anxieties uncannily mirror the ones driving national politics, rock is of course notion that to be male is to be steady, unstudied,
bigger than one gender or one emotion—ask Joan Jett or Courtney Barnett. If and tough. Linkin Park’s form of nu metal—the

30 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C Illustration by CHLOE SCHEFFE


rap-rock style in vogue around the turn of the Bizkit’s breakout hit, “Nookie,” a lewd kiss-of to
MUSIC
millennium— was polished and, for the band’s a girlfriend who treated the singer, as he told MTV,
irst few albums, notably devoid of swearing. The “like shit.”
musicians were genre benders, stitching patches of The emergence of PG-rated Linkin Park in this
hard rock, hip-hop, and new wave to a veil of soft, context was so exquisitely well timed, it invited
velvety pop. They had young fans and female fans, theories that the band had been focus-grouped
and young female fans. And they had Bennington: into life. Bennington and Shinoda’s lyrics cannily
capable of lullaby gentleness and perpetually ix- rendered rage and alienation in generic terms,
ated on his own victimhood. staging battles between an “I” and a “you,” who
could be a girlfriend, a parent, or something more
H I S B L E N D, rather than betraying the nebulous. Yet real feelings roiled. Fans often talked

T history of emotionally aggrieved popular


music, fulilled a tradition of complicating
the ideal of strong, silent masculinity. Look back
about how Linkin Park helped them through their
struggles. And interviews with Bennington made
clear where some of his own pain came from, and
at Rolling Stone’s 1969 pan of Led Zeppelin I, which that it was no pose.
described the high-pitched wails of the lead singer, When he was about 7, an older friend had begun
Robert Plant, as “foppish.” Punk balked at pre- molesting him. “I was getting beaten up and being
scribed roles and reveled in sexual transgression. forced to do things I didn’t want to do,” Benning-
New wavers like Depeche Mode knit the suppos- ton told Kerrang magazine in 2008. The sexual
edly frivolous and fey sounds of disco into their abuse continued for another six years, but he
gloom. Rock misogyny remained alive and well, remained silent about it. “I didn’t want people to
but these maneuvers encouraged men to commu- think I was gay or that I was lying,” he said, hint-
nicate in ways that would previously have gotten ing at the cost of chasing certain masculine ideals.
them labeled wimps. Instead of seeking help, Bennington turned to
Grunge, the scrufy rebellion of the early ’90s, drugs and alcohol. A cycle of addiction, recovery,
most clearly embraced the political potential of and relapse continued through two marriages, the
such an evolution. The scene was no less male births of six children, and a multiplatinum music
dominated than many rock scenes before it had career. Not long before the 41-year-old hanged
been, but its practitioners’ moans conveyed a himself at home in Southern California last July,
sense of chafing against bodily constraints and
Linkin Park’s he’d told friends he was struggling not to drink. An
cultural expec tations. In grunge, the critics music was autopsy found alcohol in his system.
Simon Reynolds and Joy Press heard “castration male rage
blues, the lailing sound of failed masculinity.” A in a form Y T H E N, L I N K I N PA R K ’ S heyday as
song like Soundgarden’s “Big Dumb Sex” brut-
ishly satirized the previous decades’ hair-metal
machismo: “I’m going to fuck fuck fuck fuck you!”
the entire
family could
B a hit-making force was long past. It had
ended in the aughts, and for nearly a
decade, nu metal was rarely mentioned by main-
Nirvana’s roaring disdain for the social hierarchies mosh to. stream critics or forward-thinking musicians. But
of Reagan-Bush America was conveyed both in whether or not the new forces on the scene—the
Kurt Cobain’s sarcastic lyrics and in his onstage likes of Skrillex and Lady Gaga—were Linkin Park
cross-dressing. Sonically, the songs thrived on fans, the band had clearly previewed the new
dichotomies of loud/soft and pretty/grating; the millennium’s pop sensibility: bombastic, melo-
efect was less to gild aggression with sweetness dramatic, and self-consciously genre busting,
than to wring drama and verisimilitude from the though always outitted with glimmering synthetic
feeling of internal conlict. textures. Meanwhile, Drake’s rise to stardom rep-
The drama was rowdily amplified by the resented a breakthrough for male sensitivity in
nu metallers of the late ’90s and early 2000s, who hip-hop, on display in an aesthetic swerve toward
experimented with rhythmic contrast by placing sinuously hybrid songs in which rap bleeds into
swampy funk and break-danceable beats amid the singing against purpled and luminous sound-
thudding of metal. If the results were ugly, so was scapes. Though they might not admit it, some of
the subject matter: pain and trauma, expressed in Drake’s fans were surely reared on Linkin Park.
even more personal terms than before. Ditching Indeed, in retrospect Linkin Park stands out as
the fantastical blather of classic metal and the a signiicant evangelist for both rock and rap. The
poetic abstractions of grunge, Jonathan Davis of band’s merging of hip-hop and guitar music was
Korn addressed his own childhood molestation by committed and proud in a way that subgenre peers
a babysitter by literally sobbing throughout 1994’s like Deftones or Korn never really matched. Linkin
“Daddy.” Grown men confessing experiences of Park had a full-time singer, Bennington, as well as
violation, real or ictional, thereafter became a nu- a full-time rapper, Shinoda, who genuinely cared
metal trope—though in many cases accompanied about his craft’s history—even if he mostly made
by a dose of bellowed machismo. Think of Limp clumsy additions to it. Between them, two forms of

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 31
musical (and often male) angst traditions achieved 2017- dominating smash. Yet dark emotion is not
MUSIC
reconciliation: the pathos and self-loathing of rock, all that distinguishes this scene. Once again in
and the aggrieved confidence of hip-hop. The pop-music history, when hard anger meets soft vul-
band’s songs read as wounded counterpunches nerability, the commingling almost always comes
against abusers, finding victory in the moment with a dose of beauty and a jolt of sonic possibility.
when the dams of internal repression broke. “I can- It also, once again, comes with troubling and inex-
not take this anymore,” Bennington hissed in the plicable real-life associations. Bennington’s death
irst line of the band’s irst single, “One Step Closer,” was the latest in a crescendo of shocks in the rock
which built up to a full-blown screaming tantrum: world, following the 2017 suicide of Soundgarden’s
“Shut up when I’m talking to you!” Chris Cornell (a close friend of Bennington’s) and
Within a tight pop framework, the underlying the 2015 fatal overdose of Stone Temple Pilots’ Scott
music looked for opportunities to hybridize as well. Weiland (whose band Bennington had played in).
Songs such as “Crawling” pushed grunge’s dichot- Meanwhile, the morbid preoccupations of Lil Peep
omies to new extremes: A synth rif like something and his peers track all too closely with urgent social
you might hear at a crystal-healing meditation har- realities like the prescription-drug epidemic and the
monizes with guitar feedback that evokes a garbage- rising rate of suicide among young people. It does
disposal jam. My own entry point as a teen was not seem coincidental that one of the biggest songs
Linkin Park’s hugely popular, Shinoda-produced of 2017, Logic’s “1-800-273-8255,” measurably
2002 remix album, which showcases a surprisingly increased calls to that phone number, the National
deep eclecticism. Some tracks intensify the band’s Suicide Prevention Lifeline.
metal edge, others turn the dial toward the airy and In the face of these dark facts, who can avoid
orchestral, and many enlist well-respected rappers pondering some sort of grim transference of
(Black Thought, Pharoahe Monch, Chali 2na). A inner torment across generations? But it is safer to
smash 2004 EP by Linkin Park and Jay-Z, Collision simply recognize that music responds to the real
Course, converted many black kids to rock fandom, world in any era because music is created by real
as tributes written since Bennington’s death attest. people. “These wounds, they will not heal” goes
“Crawling,” and the feeling that there is no future
ATELY, A WAVE of stylishly sullen young has proved true for too many pop creators. At least

L artists, many in rap, has excavated the pain-


fully unhip, angsty subcultures of the 1990s
and 2000s. Bennington’s tragedy further clari-
their music, inding new boundaries to cross and
break, escapes that fate.

ied the lines of inluence. In one fan video from Spencer Kornhaber is a staf writer at The Atlantic.
August 2017, the rapper Lil Peep leads a crowd in
black T-shirts in a sing-along of Linkin Park’s “In
the End” at an event called Emo Nite. The video
is especially moving given that Lil Peep, the
THE UNVEILING
21-year-old Long Islander born Gustav Åhr, died
of an overdose a few months after it was ilmed. A
Instead of a pebble to mark our grief
bisexual fashion-magazine muse with a tattooed
face, he seemed to present a plausible future for or a coin to ease his passage
pop, swerving between melodic hard-rock wails you placed a speaker
and mumbled hip-hop boasts. And what Lil Peep
rapped and sang about, in almost every song, was at the top of his head
drugs or suicide. His lyrics sometimes shouted out and suddenly a drumbeat
Cobain, who killed himself at 27 in 1994, and in
one music video he glowered in front of a portrait came blasting out of the grass,
of Amy Winehouse, who died at 27 in 2011. startling the mourners on the far side
Dystopian though the thought is, Lil Peep
of the cemetery, clanging the trees,
exemplified the arrival of self-annihilation as a
trending topic for a new generation of performers scattering the swifts
who borrow from nu metal, grunge, emo, and punk. that had gathered around the stone
The anti-anxiety medication Xanax is to many
of today’s rappers what Patrón was to rappers a like souls of the dead,
decade ago, and self-harm is referenced routinely. souls that were now parting
One breakout duo is named $uicideboy$, and Edward Hirsch’s to make way for a noisy spirit
the controversial XXXTentacion, another rising most recent
star who loves Cobain, pretended to hang him- book is Gabriel: rising out of the dirt.
self on Instagram. “Push me to the edge / all my A Poem (2014).
friends are dead,” went the chorus to Lil Uzi Vert’s — Edward Hirsch

32 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C Illustration by MELINDA JOSIE


“First Republic always inds a way to help us
with creative options and solutions.”
J O N AT H A N O ’ B R I E N, Chief Operating Oicer, Proskauer Rose LLP
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MEMBER FDIC AND EQUAL HOUSING LENDER
As Gwendolyn Oxenham writes in Under the
Lights and in the Dark: Untold Stories of Women’s
Soccer, Nadim played with friends and by her-
self, juggling the ball for hours. Eventually she
approached the coach in the town ields, and he
BOOKS
invited her to join his team. In her irst game, she

The Wrong Way scored three goals. From there, a string of youth
coaches nurtured her talent. She graduated from

to Scout for high school and college, and eventually attended


medical school; she also became a professional

Soccer Talent soccer player. Today, she is a star of the Danish


national team and, after becoming a member of
the Portland Thorns, one of the top women’s pro-
fessional teams in the United States, now plays for
An intense winnowing process, starting Manchester City, in England.
when players are very young, may fail to spot Bernard Appiah grew up in Teshie, a poor sea-
the gifts that are crucial to the game. side town near Accra, Ghana. He played soccer
constantly as a young boy, and when he was about
BY LAURENT DUBOIS 8, a coach recruited him to a local team. The team
had 50 players but only two soccer balls, so, as
Sebastian Abbot writes in The Away Game: The Epic
Search for Soccer’s Next Superstars, they spent much
of their time in practice “simply running around in

I
N 2001, NADIA NADIM, a 12-year-old Afghan girl living with the dust.” Appiah outplayed everyone, earning
her mother and sisters in a Danish refugee center, looked up and the nickname “The Tornado.” Soon after, another
noticed a soccer ball in the branches of a tree. On the other side local coach recruited him to a better team, one
of a nearby fence were lush soccer ields where youth teams from with proper equipment and a good practice ield,
the local town practiced. Players sometimes sent balls lying into hoping to nurture his talent for a professional
the woods near the center. Spotting more, Nadim and her friends career in Ghana or abroad in Europe.
shook the trees and threw some of the balls back over the fence. In 2007, a Spanish coach named Josep Colomer
They kept a few older ones so they could play, too. came to Teshie on a irst-of-its-kind tour of Africa

34 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C I l l u s t r a t i o n by J O N AT H A N B A R T L E T T
in search of the best young players he could ind. scale. Many promising young players sign con-
BOOKS
On ofer were three scholarships to Aspire Acad- tracts with clubs whose inances depend on buy-
emy, a lavishly endowed new soccer-training pro- ing and selling those contracts in an international
gram in Qatar that boasted a stadium, six ields, market. The “transfer fees” exchanged between
and speakers that piped in “the sounds of birds clubs have risen vertiginously over the past few
chirping throughout the day.” Appiah, at that point decades. Last summer, Paris Saint-Germain, a
a young teen, was chosen as one of the best play- team bankrolled by Qatari investors, set a record
ers in Ghana, and was brought to the Aspire Acad- by buying the Brazilian star Neymar from Bar-
emy, along with 23 other players from throughout celona for $263 million. For top players, as well
Africa, for the inal tryouts. He was awarded one as the clubs and intermediaries involved in the
of the coveted scholarships, and began what was soccer market’s chains of speculation, there are
supposed to be a multiyear program of honing his fortunes to be made. For the masses of aspiring
talents. His coaches pegged him as the next Lio- players, whose chances of succeeding are inin-
nel Messi, whom Appiah met when the Argentine itesimal, the costs are human and in many cases
superstar visited Aspire. Today, however, Appiah quite brutal.
lives in relative poverty in Ghana, his dreams—and Abbot and Oxenham offer us riveting por-
those of the coaches and institutions that invested traits of players trying to make it, bouncing from
in him—largely evaporated. team to team and continent to continent, often in
Soccer is the most popular sport on the planet, deeply precarious circumstances. Their accounts
a universal language like no other. Billions of peo- raise questions about the ethics and efectiveness
ple play and watch the game. Many of its great- of the current soccer system. Does the ruthless
est players, like those in other sports, have come “Game selection that male athletes face—driven by a top-
from the margins of society. Part of what draws down structure, an emphasis on early winnowing,
multitudes is that soccer is a place of possibility,
intelligence” and intensive youth training—go against the grain
where even those born into the most diicult of can be of a game based on shifting, unpredictable play?
circumstances can become global icons, cele- nurtured, And might women’s careers, which unfold dif-
brated for playing a game that explodes with joy but it is ferently because of the gender inequalities that
and creativity. shape a notably underfunded sport, have some
Yet the men’s side of professional soccer has
difficult lessons to ofer?
given rise to a merciless process of talent identii- to teach.
cation and development that operates on a global T A R T I N G I N T H E 1 9 8 0 S , European

S nation al teams and professional clubs


began organizing youth academies aimed at
identifying and cultivating male players at a very
young age. Those academies have now spread all
over the continent, and the competition among the
kids there, some brought in as young as 5 years old,
is ierce. A recent study of English academies, cited
by Abbot, concluded that out of about 10,000 kids
in the system, roughly 100 will become profes-
sionals. And among those who do get professional
contracts as teenagers, two-thirds will no longer be
playing by the time they are 21.
The net is cast wide at the youth level because it
is so diicult to determine which players have the
talent, skills, and drive that will allow them to suc-
ceed. Soccer doesn’t require a particular body type.
Lionel Messi is 5 foot 7 and sufered from growth-
hormone deiciency as a child, but was neverthe-
less recruited to the Barcelona academy when he
was 11. Nicknamed “The Flea” by his teammates,
he had amazing technique with the ball and con-
sistently outplayed them. As he matured, Messi
stood out thanks above all to what coaches call
“game intelligence”—“the ability,” as Abbot puts it,
“to evaluate a dynamic situation and execute the
right decision almost instantly.”
Game intelligence can be nurtured, but it is dif-
icult to teach. The only sureire way to cultivate it

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 35
is to play a lot. And the more structured training Called Football Dreams, the enterprise was, Ab-
approach taken by many academies may, iron- bot writes, “the largest soccer scouting project in
ically, be a hindrance. Abbot invokes research history.” The irst year, when Appiah was selected,
suggesting that play in informal environments— nearly 430,000 boys participated in the tryouts. By
on a patch of dirt or in the courtyard of a hous- 2014, more than 3.5 million youths had been scouted
ing project, for example, rather than on a well- by the program. At one ield in Ghana, more than
manicured pitch under adult supervision—is key 100 young players showed up two days early, sleep-
to the development of game intelligence. In these ing on the ground while they waited for Aspire
settings, kids also tend to one-up each other with Academy representatives to arrive. In the irst year,
lashy play—dribbling adroitly around someone, Colomer persuaded Jassim to expand the number
kicking the ball over a head or through a thicket of scholarships awarded by setting up an academy
of legs, juggling the ball in the air for a while, ex- in Senegal, which welcomes 20 students a year, in
ecuting a back-heel pass to a teammate—which is addition to the few who get to train in Qatar. Still, as
a great way to master technical skills. Such pickup
In soccer’s Abbot notes, the winnowing process is “a thousand
games demand creativity and improvisation, global order, times more selective than getting into Harvard.”
and reward those who are constantly observing Africa is
their surroundings and recalibrating their moves seen as a F Y O U N G P L AY E R S thronged to the try-
accordingly. Coaching is no doubt useful, but
even players at academies do better when they
spend a lot of time in free-form play.
supplier of
raw material
I outs, it was because Aspire Academy seemed
to point the way to a professional career in
Europe—the dream that drives soccer throughout
No wonder, then, that Africa, which over the to be refined Africa. At 8, Appiah was already a commodity. His
past several decades has produced some of Eu- and then second youth coach, Justice Oteng, paid an infor-
rope’s greatest soccer stars, has beckoned as a mal transfer fee for him and other players when
vast and untapped recruiting ground. Structured
sold on the they joined the team. Oteng also paid for the
academy training of the kind now prevalent in international Ghana Football Association license that qualiied
Europe is rare there. The next star, the thinking market. Appiah to play in the country’s oicial leagues, and
goes, could be anywhere, honing his talents under he provided housing for several years.
an overpass in Lagos or oceanside in Dakar. The For Oteng, these were speculative investments
prospect appealed to Sheikh Jassim, the founder that he hoped to recoup one day. Like Oteng, how-
of Aspire Academy. In line to be the next emir of ever, most local coaches don’t have direct links to
Qatar, Jassim had renounced the throne to focus European clubs. So young players end up vulner-
on his true passion, soccer. (A doctor once sum- able to unscrupulous agents, many of whom de-
moned to his palace to cure his insomnia saw the mand money up front and never follow through on
problem immediately: wall-to-wall screens in the promises to introduce players to recruiters. Such
bedroom, showing games being played all over the a large number of aspiring African players are left
world, around the clock.) Setting out to train a great stranded and homeless in Europe that one retired
Qatari team, Sheikh Jassim decided that import- soccer player has created an NGO in France to help
ing talented African players would help, and hired them. He describes this trade in young players as a
Josep Colomer to search the continent. kind of “modern slavery.”

battle is learning to builds as Sonja’s inner to the countryside


COVER TO COVER drive. Shifting gears is world unfolds. Stuck where she grew up,
a challenge for Sonja, in a driving lesson and especially to her
Mirror, Shoulder, a translator of Swedish or on her massage estranged sister. But
Signal crime fiction who lives therapist’s table, she gauzy nostalgia isn’t
in Copenhagen and is is elsewhere, too, as in her middle-aged
DORTHE NOR S,
TRANSLATED BY prone to bouts of dizzi- if she’d “pressed an repertoire as she nav-
MISHA HOEK STRA ness. Even working up elevator button in her igates the terrifying
G R AY WOLF the nerve to change mind.” An unmoored, on-ramp to the future
driving instructors is lonely soul in a big alone. “As women,”
THE DANISH WRITER in The Paris Review. a struggle. city, she’s grappling she says of herself
Dorthe Nors likes to For the 40-something Only a writer as with “the things and her mother in a
subject her characters protagonist of her lat- agile and profound as she cannot find the rare moment of dia-
to “the battle that you est novel—the first to Nors would dare to language to say and logue, “we’re not com-
experience on the appear in English, and proceed from such a the people she most pletely fine-tuned.” As
brink of something a finalist for the Man heavy-handed (and wants to say them to.” a novelist, Nors comes
new,” she explained Booker International humdrum) premise. Sonja’s thoughts remarkably close.
in a 2014 interview Prize last year—the The novel’s power return again and again — Ann Hulbert

36 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Football Dreams was presented by its leaders might not have felt the need to leave home to hone
BOOKS
as an alternative to this kind of exploitation. Yet his talents, and when the time was right—when he
as Appiah discovered, the pressures of the indus- was old enough, and ready—he could have made a
try are inescapable. With the eyes of European move to Europe. Recruiters could still travel Africa
teams on him as he played exhibition matches looking for star players, but they would be looking
with Aspire, a conlict developed between Oteng for young men rather than boys, and have a better
and the academy over when he should go profes- chance to truly judge whether they were ready for
sional and who would negotiate, and proit from, European club soccer. Cutting back on intensive
the move. The struggle over Appiah’s future even- training in childhood might have downsides, of
tually short- circuited it. He left Aspire Academy course. Yet the gains, especially for the many play-
after a year, and his attempts to get a contract in ers who never become stars, could be seen as com-
Europe loundered, despite his top-level training pensation enough.
and connections to coaches there. He ended up
playing professionally in Ghana, where the pay is H E W O R L D O F women’s soccer por-
low: The going salary is about $50 a month, which
sometimes is barely enough for food and shelter.
Now in his mid-20s, he remains optimistic that he
T trayed by Oxenham provides inspiration
here. To be sure, the absence of big money
doesn’t mean freedom from exploitation. Most of
will get a break, but time is running out for him to the players we meet in Under the Lights and in the
have a professional career in Europe. Dark are barely eking out a living, even in the U.S.
Describing Appiah’s departure from the acad- league, which is better-funded than most coun-
emy, Abbot writes that he was “headed back to tries’ leagues. Marta Vieira da Silva, a star of Bra-
the mine where he was found.” The echoes of zil’s national team—and considered by many to be
colonialism are clear. In soccer’s global order, the world’s greatest female soccer player—earns
Africa is seen as a supplier of raw material to be about $40,000 a year playing with the Orlando
refined and then sold on the international Pride, though she makes more from commercial
market— or, far more likely, discarded. Encour- endorsements. The inancial realities reshape the
aged to stake everything on the game, young entire process and ethos of women’s soccer. Young
players confront intense expectations and inan- players can only ever think of soccer “not as a des-
cial pressures. One of Appiah’s classmates at the tination but as a route,” writes Oxenham, once an
academy did ultimately go professional in Europe, aspiring professional player herself. “From the
playing for a year with Barcelona and then with beginning of our playing careers, we prepared for
a lesser-known team. A few more-recent Aspire the end.”
graduates have gone professional as well. Still, That means the path for even the most skilled
Abbot’s book paints a portrait of institutions so and ambitious girls begins as, and remains, a
obsessively geared toward producing the next broader one. Like Nadim, one of the American
star that little thought is given to what is con- players in Oxenham’s book attends medical
sumed, and lost, in the endeavor. school; a star of the German national team is in
the police academy. “I can’t just be a soccer player,”
H AT I F T H E S Y S T E M were struc- she explains. “I’d be bored.” Gaëlle Enganamouit

W tured diferently, focused on the expe-


riences of the vast majority of aspiring
players who will fail rather than on the tiny number
THE AWAY GAME:
THE EPIC SEARCH
FOR SOCCER’S NEXT
SUPERSTARS
of Cameroon uses the money she earns playing
professionally to invest in a taxi business run by
her family back home.
who will succeed? This would be more ethical and SEBASTIAN ABBOT Nadim discovered soccer for herself, and got
less exploitative, and might well produce just as W. W. Norton her teenage training thanks to the generous gov-
many great stars, at a much lower personal price. ernment support—local and national—for youth
As Abbot’s book highlights, the Aspire Academy sports throughout Denmark. She saw the ball in
quest has yielded strikingly mixed results, espe- the tree in part because well-equipped programs
cially given the massive investment involved. A meant that young players didn’t bother to go after
blunt truth emerges: Seeking out players when the balls they kicked into the woods. A dose of that
they are very young is surely not an ideal formula spirit, spreading soccer’s benefits wider, would
for scouting success. The development of game serve everyone, including stars. Soccer, at its heart,
intelligence remains fairly mysterious; the asset is all about creating openings where there seem to
is one whose eventual emergence can be hard to be none. Utopian though the dream of a more just
predict early on. and equitable soccer system may sound, that’s only
What boys like Appiah may need most of all is UNDER THE LIGHTS more reason to nurse it.
AND IN THE DARK:
more time, and a comparatively modest space up-
UNTOLD STORIES OF
grade. Instead of six practice ields in Qatar, he and WOMEN’S SOCCER
Laurent Dubois teaches at Duke University and is
other young players could have used another good GWENDOLYN OXENHAM the author, most recently, of The Language of the
one in Teshie. With better conditions there, he Icon Game: How to Understand Soccer.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 37
This content was created by Atlantic Re:think, the branded content studio at The Atlantic, and made
SPONSOR CONTENT possible by WeWork. It does not necessarily reflect the views of The Atlantic’s editorial staff.

Φ

F U T U RE
Is

HUMAN
Enterprising workers are
moving to cities in droves.
But as economic forces
threaten to pull us apart,
transforming work and life
As cities get denser, the modern A number of urban centers are at
as we know it, we must workforce is being transformed by pow- the forefront of addressing this change,
embrace community and erful forces like automation and global which is one big reason why cities in the
competition. Looked at in one way, these U.S.—and around the world—are now on
pave the way for a rising
are forces that could eventually turn us the rise. And not just cities like New York
generation of entrepreneurs. against each other, instilling in people a and London. From Kansas City to Denver,
sense of alienation and uncertainty that São Paulo to New Delhi, cities are all grow-
can make urban life lonely and the future ing as young entrepreneurs migrate en
of work seem ominous. masse to urban areas, forming a constella-
tion of enterprise that dots the globe.
Companies must reimagine That may sound bleak, but there is plenty
their work spaces to support of reason for hope. According to experts, Recently, Long Beach, California, lost a
innovation and encourage
connection and creativity. the disruptions to urban work life also giant Boeing manufacturing facility, which
have the potential to bring us closer decimated the local economy. Rather than
together if harnessed correctly, giving shying away from the consequences of
cities—and the companies that operate technological innovation, though, Long
therein—the chance to create new hives Beach was determined to embrace them.
of meaningful social interaction that can The city set about connecting employers
enrich local economies. with freelancers, who make up 30 percent
of the population, and brought WeWork,
“People tend to work better together,” says the co-working giant, to its downtown
Ethan Pollack, an associate director of area last year.
research and policy for the Aspen Insti-
tute’s Future of Work Initiative. “Humans Since then, Long Beach has seen a hearty
are inherently social beings, so as work revival of its business district. WeWork’s
becomes more independent, it further introduction to the area acted as a kind of
emphasizes the need to create other ways binding agent and economic accelerant,
that people can connect with each other.” allowing entrepreneurs and enterprises
SPONSOR CONTENT

WeWork’s Economic
ɕʝʝɬ*Ψ ʲ
“WeWork is now a critical
piece of our economic
development, job
70%–80%
70%–80% of WeWork members in New York,

creation, and downtown Los Angeles, and Chicago are new to their
neighborhood—bringing economic

revitalization strategy.” activity to local restaurants and shops.

Robert Garcia
Mayor of Long Beach, California
12%
New businesses are 12% more
likely to survive at WeWork than
are their peers, and 45% of member
companies credit WeWork with helping
to seamlessly connect within Long Beach of companies and entrepreneurs allows accelerate their growth.
and in cities around the world. “I think We- members to tap into and realize value
Work can be a game changer for the future from these economic spillovers within
of cities,” says Robert Garcia, the mayor of
Long Beach.
their local communities and across cities.”
2x
The story of a newly revitalized city like The WeWork community creates a power-
This change begins with one block, one Long Beach can serve as a model for ful economic multiplier for cities:
neighborhood, one city—but these are other locales. But thriving economies 10,000 WeWork members can create an
additional 10,000 jobs in the local economy
just the start. If you can connect people in aren’t assured. The future depends, in
through indirect and induced spending.
meaningful ways, then neighboring cities large part, on how we respond to loom-
like Long Beach and Los Angeles, for in- ing changes. We can fear technological
stance, won’t be solely dependent on each advancement. We can fear a world that
other for symbiotic working relationships is becoming more interconnected by
and shared intellectual resources. The the day. We can turn inward and against Read the full report at
network can go beyond physical location: those around us. Or we can embrace we.co/weworkimpact
A growing small business in Long Beach, change with optimism and action. We
for example, can easily collaborate with can lasso the forces that threaten to pull
designers in Detroit and an engineering us apart and humanize both cities and
team in San Francisco while it negotiates
a partnership with a Fortune 500 company
in Chicago and sells to clients from New
York to Mexico City to Shanghai—creating For more on how cities can
build a community for the
a borderless string of entrepreneurship future, visit:
and cities around the globe.
theatlantic.com/future-is-human

“WeWork has created the physical-


world equivalent of a digital platform,
creating value by imprinting design onto
SOURCE
physical space, which leads to network
Eਬ˓ɕʧʂʠʧ
effects at both the individual and institu- ÃÃʂʠɧ*ʂɸʂɵɕ
tional levels,” says Arun Sundararajan, a JɵʝȊʲʝʂʠʲ
professor at New York University’s Stern
School of Business and the author of The
Sharing Economy. “Its global constellation
in 1700, not yet 40, childless and sterile. Geneti-
cists have calculated that he was more inbred than
he would have been had his parents been siblings.
After his death, the Spanish Habsburg dynasty
collapsed, crushed under the weight of a heredity
that as yet had no name.
BOOKS
Though Renaissance nobles could not have
missed the unfortunate traits that ran like fractures
Your DNA Is Weirder through the House of Habsburg, not until the 1830s
did the term heredity acquire its modern conno-
Than You Think tation as a biological legacy. Because the term irst
speciied material inheritance, often from eldest
Genetic research constantly upends our understanding son to eldest son, we tend to think about heredity
in terms of straight lines: bloodlines, patrilines,
of heredity—though not our zeal to control it. and eventually germ lines. Our word for a dia-
BY NATHANIEL COMFORT
gram of the lines of descent—pedigree—is probably
derived from the French pé de grue, or “crane’s
foot,” evoking an image of a pencil-like leg ending
in straight, splayed toes.
Yet linear thinking doesn’t begin to do hered-
ity justice, and in his sprawling, magisterial new

I
N 1555, Holy Roman Emperor Charles V announced his plans book, the science writer Carl Zimmer shows why.
to abdicate, and his 28-year-old son, Philip II, became the king She Has Her Mother’s Laugh brims with rich stories
of Spain the following year. The throne was Philip’s natural— and colorful actors—some sinister, some brilliant,
hereditary—right. The Habsburg dynasty, to which Charles and some both—and delves into scientiic research,
Philip belonged, had raised strategic matrimony to an art form, history, and ideas made intimate through the au-
using marriage bonds among relations distant and close to seize thor’s personal experiences. The result explodes
control over much of Europe. Power came with a price, however: any unitary idea of heredity. Zimmer limns por-
severe, recurring mental and physical problems. Charles’s traits of multiple intersecting heredities, more
mother was Joan the Mad; his son Philip was said to be “of weakly frame and like the web of a spider than the foot of a bird.
of a gloomy, severe, obstinate, and superstitious character.” Philip’s descen- Despite this proliferation, dreams of human con-
dant Charles II was 4 before he could talk and 8 before he could walk. He died trol over the process continue to soar.

40 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C I l l u s t r a t i o n b y M AY U KO F U J I N O
The biological concept of heredity came too and exhibits masculinized behavior (and is particu-
BOOKS
late for the Habsburgs, but not for Francis Galton, larly tasty on the grill). Where does one calf end and
a half-cousin of Charles Darwin. When Galton the other begin?
looked at distinguished pedigrees in the 1860s, Zimmer describes a bizarre twist on the free-
he saw concentrations of virtues: intelligence, martin: a girl with different-colored eyes and
good looks, strength of character. This Victorian ambiguous genitals who appeared at a Seattle
gentleman, who gave us the phrase nature versus genetics clinic. Her ovaries proved to have only
nurture, convinced himself that talent and charac- XX chromosomes—typical female—but her other
ter were hereditary, because they ran in families. tissues were mixtures of XX and XY. Further
After abandoning the awkward word viriculture, he analysis showed that she had started out as oppo-
christened the science of hereditary improvement site-sex twins. But early in development, the two
“eugenics,” from the Greek for “wellborn.” embryos had fused, becoming a single, highly un-
Galton’s eugenic scheme relied on persuasion usual child. Like a verse from the old Ray Stevens
and social incentives to discourage those he con- novelty song “I’m My Own Grandpa,” this girl was
sidered unit from reproducing, while encourag- her own twin brother.
ing procreation among the posh and brilliant. The But chimeras are not just oddities. You surely
result, he earnestly believed, would be a “galaxy of know one. In pregnant women, fetal stem cells
genius.” Later editions of eugenics were less opti- can cross the placenta to enter the mother’s blood-
mistic. If you take Galton’s recipe, add Mendel’s It is all stream, where they may persist for years. If Mom
peas and Morgan’s fruit lies, simmer in the politics gets pregnant again, the stem cells of her irstborn,
and culture of the Progressive era, and stir vigor-
too easy to still circulating in her blood, can cross the placenta
ously, you get the American eugenics movement— scoff at the in the other direction, commingling with those of
dogmatic, ideological, and coercive. (Sadly, some monstrous the younger sibling. Heredity can thus low “up-
choice examples of its rhetoric may be found in the confidence stream,” from child to parent—and then over and
archives of this magazine.) Serve warm to German down to future siblings.
fascists, and you get the Final Solution.
that led The genome, Zimmer goes on to reveal, eludes
It is all too easy to shake our heads at the cruelty eugenicists to tidy boundaries too. Forget the notion that your
and naïveté of the eugenic creed, which held that believe they genome is just the DNA in your chromosomes. We
society could be “cured” of crime, disease, and understood have another genome, small but vital, in our cells’
poverty by eliminating the “unit” from the gene mitochondria—the tiny powerhouses that supply
pool, or to tsk-tsk at the monstrous conidence that
heredity well energy to the cell. Though the mitochondrial genes
led eugenicists to believe they understood heredity enough to are few, damage to them can lead to disorders of
well enough to engineer it. Much more diicult is engineer it. the brain, muscles, internal organs, sensory sys-
to bear in mind that in 20 years, many of today’s tems, and more. At fertilization, an embryo re-
received truths will also be thought wrong. Playing ceives both chromosomes and mitochondria from
God is always harder than it looks. the egg, and only chromosomes from the sperm.
Mitochondrial heredity thus lows strictly through
T E P B Y M E A S U R E D S T E P, Zimmer the maternal line; every boy is an evolutionary

S walks us deep into the thickets of genetics


and genomics, revealing complications and
exceptions that challenge what we think we know
dead end, as far as mitochondria are concerned.
Beyond the genome are more surprises. School-
children learn that Darwin’s predecessor, the great
about heredity. Following his own family tree, Zim- French naturalist Jean-Baptiste Lamarck, got
mer shows us that counterintuitive facts lie even in heredity wrong when he suggested that traits
the humble pedigree. If you pursue your lineage far acquired through experience—like the giraffe’s
enough, the branching forks of a family tree begin neck, elongated by straining and stretching to
to rejoin, such that if your ancestry is European reach higher, perhaps tenderer, leaves—could be
back to the time of Charlemagne, you are related passed down. The biologist August Weismann
to Charlemagne himself! famously gave the lie to such theories, which col-
To focus in is to ind chromosomes playing all lectively are known as “soft” heredity. If Lamarck-
sorts of tricks. Take, for example, chimeras. To the ism were true, he said, chopping the tail of mice
ancient Greeks, the Chimera was a ire-breathing and breeding them, generation after generation,
hybrid monster; to a biologist, chimeras are organ- should eventually produce tailless mice. It didn’t.
isms that comprise cells from two diferent individ- SHE HAS HER Lamarck wasn’t lurking in the details.
uals. Ranchers are familiar with one type of chimera, MOTHER’S LAUGH: Recent research, however, is giving Lamarck a
the freemartin, which results when a cow carries THE POWERS, measure of redemption. A subtle regulatory sys-
PERVERSIONS, tem has been shown to silence or mute the efects
opposite-sex twins. Connected by a shared placenta,
AND POTENTIAL
the fetal calves exchange stem cells. The bull calf OF HEREDITY
of genes without changing the DNA itself. Envi-
grows up into a more or less normal bull, while the CARL ZIMMER ronmental stresses such as heat, salt, toxins, and
heifer—the freemartin—has undeveloped ovaries Dutton infection can trigger so-called epigenetic responses,

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 41
turning genes on and of to stimulate or restrict The ethics of some reproductive technologies
BOOKS
growth, initiate immune reactions, and much become blurrier in light of the newly complex
more. These alterations in gene activity, which are understanding of heredity’s cross currents. A
reversible, can be passed down to ofspring. They maternal surrogate, for example, will likely ex-
are hitchhikers on the chromosomes, riding along change stem cells with the fetus she carries, open-
for a while, but able to hop on and of. Harnessing ing the door to claims that baby and surrogate are
epigenetics, some speculate, could enable us to related. If the surrogate later carries her own baby,
create Lamarckian crops, which would adapt to a or that of a diferent woman, are the children re-
disease in one or two generations and then pass the lated? Parenthood becomes even stranger with
acquired resistance down to their ofspring. If the so-called mitochondrial-replacement therapy. If
disease left the area, so would the resistance. a woman with a mitochondrial disorder wants
All of these heredities— chromosomal, mito- a biological child, it is now possible to inject the
chondrial, epigenetic—still don’t add up to your nucleus of one of her eggs into a healthy woman’s
entire you. Not even close. Every one of us carries egg (after removing its nucleus), and then perform
a unique lora of hundreds if not thousands of mi- in vitro fertilization. The result is a “three-parent
crobes, each with its own genome, without which baby,” the irst of which was born in 2016. Zimmer
we cannot feel healthy—cannot be “us.” These doesn’t presume to make ethical judgments about
too can be passed down from parent to child—but procedures such as this, but warns that “informed
may also move from child to adult, child to child, consent” in such cases can be unexpectedly thorny.
stranger to stranger. Always a willing volunteer, And why stop with people? A so-called gene
Zimmer allowed a researcher to sample the mi- drive could enable researchers to release into
crobes living in his belly-button lint. Zimmer’s nature organisms that would genetically engineer
“navelome” included 53 species of bacteria. One one another, spreading a desirable trait through-
microbe had been known, until then, only from out a population within a couple of generations.
the Mariana Trench. “You, my friend,” the scien-
Every one of Scientists imagine using this process to create
tist said, “are a wonderland.” Indeed, we all are. us carries a pest-proof crops, malaria-free mosquitoes, and
unique flora limitless other innovations in agriculture and pub-
I T H T H I S I N M I N D, reconsider the of hundreds if lic health. Trials are in progress.

W ongoing effort to engineer heredity.


The motto of the Second International
Eugenics Congress, in 1921, was “Eugenics is the
not thousands
of microbes,
Engineering the global genome could save mil-
lions of lives—or produce a chimeric hybrid of Gat-
taca and Jurassic Park. We could alter the gene pool
self-direction of human evolution.” Since then, each with its of the future in ways we cannot yet even imagine,
controlling heredity has become technically much own genome, let alone understand. Zimmer is excited about the
easier and philosophically more complicated. When, possibilities, but in a world where headlong innova-
in the 1970s, the first genetic engineering made
without which tion always trumps careful contemplation, he urges
medical gene therapy feasible, many of its pioneers we cannot scientists and the public to learn from history. “We
urged caution, lest some government try to create be “us.” would do well,” he writes, “to look back at how the
a genetic Fourth Reich. In particular, two taboos tools we’ve already invented have altered our eco-
seemed commonsense: no enhancement, only logical inheritance over the past ten thousand years.”
therapy (thou shalt not create a master race); and An old saw of biology runs “Evolution is clev-
no alterations in germ-line tissues, only in somatic erer than you are.” And ecology, involving as it
cells (thou shalt not make heritable modiications). does the dovetailed evolution of countless organ-
To today’s genetic engineers, those parameters isms in a constantly changing world, is cleverer
seem quaint. Researchers can now convert mature than evolution. In Zimmer’s pages, we discover
somatic tissue taken from, say, a cheek swab into a world minutely threaded with myriad streams
stem cells able to become any type of cell, even of heredity lowing in all directions, in variegated
sperm and eggs. New technologies such as the patterns and diferent registers—from a newt’s
gene-editing technique known as CRISPR have truncated, regenerating tail; to the pond in which
greatly expanded the repertoire of engineering. the newt paddles; to the meadow where the pond
Ethical quandaries abound. Although injecting ills and dries, ills and dries, down the centuries.
the hormone erythropoietin can be lifesaving for The computing power alone required to play pup-
people with severe anemia, it is illegal for athletes. pet master for such a scene, tugging and twirling
What about gene therapy to raise one’s “natural” the strings of its DNA, is staggering. Whether we
erythropoietin production? Is it better to elimi- have the wisdom to nurture nature is a question
nate gene variants for sickle cell anemia and thal- that Zimmer leaves, held aloft like a dandelion
assemia, or to retain the malaria resistance those puf, for us to contemplate.
genes confer? What kinds of side effects would
seem tolerable in order to raise your child’s IQ by Nathaniel Comfort is a professor of the history of
a few points? medicine at Johns Hopkins University.

42 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
It’s time to say NO to trying to fit square-peg kids
into round holes, and YES to raising them from
a place of acceptance and joy.

T oday one out of five kids has ADHD,


dyslexia, autism, giftedness, anxiety, or
other neurodifferences. These are children that
Deborah Reber, bestselling author and mother of
a twice-exceptional son, calls “differently wired,”
and the challenges of raising them are many. Now,
weaving together personal stories with a tool kit
of expert advice, she offers a groundbreaking
how-to and manifesto that will help parents help
their children fully realize their best selves.

“Differently Wired will help parents of


children who think differently to accept their
child for who they are and facilitate their
successful development.”
—TEMPLE GRANDIN, author of Thinking
in Pictures and The Autistic Brain

“A wonderfully engaging and much-needed


book that I will enthusiastically recommend
to so many parents and professionals I meet
on a regular basis.”
—BARRY M. PRIZANT, PhD, CCC-SLP, author of
Uniquely Human: A Different Way of Seeing Autism

“A ‘must read’ for all parents raising children with multiple exceptionalities.”
—DR. MICHAEL POSTMA, EdD, interim director of SENG
(Supporting the Emotional Needs of the Gifted)

“Building on the premise that we should celebrate our children’s uniqueness


instead of apologizing for it, Deborah Reber provides real tools and
practical advice for parents to confidently support their child’s journey.”
—AMANDA MORIN, Writer/Expert at Understood and author of
The Everything Parent’s Guide to Special Education

Available now, wherever books are sold.


Here’s one way to ight ISIS: Send one
of the most advanced and expensive
military aircraft in the U.S. arsenal from
a base in Missouri to drop GPS-guided
500-pound bombs on a group of
70 ragtag ighters sleeping in the Libyan
desert. (Spoiler alert: They died.)

44 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
T
H
E
BY WILLIAM LANGEWIESCHE
I L LU ST R AT I O N S BY OW E N F R E E M A N

R
A
I
D
School, in Nevada. The airplanes had been fawned over for days
by ground crews, but in ine aeronautical tradition the respon-
I. sibility for their condition lay ultimately with the pilots. They
TARGET loaded their gear into the cockpits, gaining access by climbing
a short ladder and pulling themselves up through a hatch in
The B-2 stealth bomber is the world’s most exotic strategic air- the loor. They then performed a traditional walk-around, fol-
craft, a subsonic lying wing meant to be diicult for air defenses lowed by extensive system checks and light-plan entries. This
to detect—whether by radar or other means—yet capable of carry- took about 90 minutes. No problems were discovered. They
ing nearly the same payload as the massive B-52. It came into ser- closed the cockpit hatches, strapped into their seats, and while
vice in the late 1990s primarily for use in a potential nuclear war still in the hangars started their engines. Each B-2 has four jet
with the Soviet Union, and clearly as a irst-strike weapon rather engines—not clunky cylinders but turbofans embedded sleekly
than a retaliatory one. First-strike weapons have destabilizing, in the wings, like gills in a shark, so as to limit radar, infrared,
not deterrent, efects. It is probably just
as well that the stealth bomber was not
quite as stealthy as it was meant to be, and
was so expensive—at $2.1 billion each—
that only 21 were built before Congress
refused to pay for more. Nineteen of
them are now stationed close to the geo-
graphic center of the contiguous United
States, in the desolate farmland of central
Missouri, at Whiteman Air Force Base.
They are part of the 509th Bomb Wing,
and until recently were commanded by
Brigadier General Paul W. Tibbets IV,
whose grandfather dropped the atomic
bomb on Hiroshima. B-2 bombers are still
primarily regarded as a nuclear-delivery
system, meaning that their crews are by
selection the sort of men and women
capable of deining success as a precisely
lown sortie at the outset of mass annihi-
lation. No one should doubt that, if given
the order to launch a nuclear attack, these
crews would carry it out. In the meantime,
they have occasionally lown missions of
a diferent sort—make-work projects such
as saber rattling over the Korean penin-
sula, and the opening salvos in Serbia,
Afghanistan, and Iraq—to tactical advan-
tage without American discomfort.
Such was the state of affairs in the
small hours of the morning at Whiteman
on January 17, 2017, during the last days
of the Obama administration. Six years
had passed since any B-2 had lown in combat. But now, in the and acoustic signatures. The engine start is automated—a push-
privacy of their bespoke, climate-controlled, single-occupancy button afair that requires monitoring but rarely fails.
hangars, several of them had been loaded with 80 GPS-guided Once the engines had started, the B-2s emerged in unison
bombs for use against enemies who had been spotted on the from their hangars and pivoted to form a single-file line. A
ground in a faraway country. The preparations had been hushed: low overcast blackened the sky. The air was cold and moist—
Relatively few people on the base, even among those assembling conditions conducive to engine-induction icing while the plane is
and loading the bombs, knew that this was something other than idling on the ground, one of several weather-related weaknesses
a training run. from which the B-2 sufers as a result of the uncompromising pur-
In the B-2, the only inhabitable space is the cockpit, and the pose of its design. Because of the potential for icing, the pilots
light crew consists of merely two people. Though they are cross- were eager to get their ships into the air. Spaced 500 feet apart,
trained to perform any role in light, the one in the right seat is the B-2s taxied briskly toward the top of the runway—an array
the mission commander, who handles the weapons and military of wings with no fuselages, no tails, and no vertical stabilizers,
communications, and the one in the left seat is considered the barely recognizable as airplanes except for their hefty landing
pilot, who performs the lesser tasks of lying the airplane and gear and the whine of their hidden engines. The irst three took
dealing with air traic control. On that January morning, all of 30 seconds apart and were swallowed by the night. The others,
of the crew members were mid-ranking men and graduates of which had been spun up in case the primary aircraft experienced
advanced B-2 training at the United States Air Force Weapons problems, taxied back to their hangars and shut down. When I

46 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
later expressed surprise at this level of redundancy, one of the minute, doing a relatively sedate 320 miles an hour. Once they
pilots explained that it had been necessary to ensure the bombs reached the mid-30,000-foot range, they cruised, maintaining a
would be released at the chosen time: within the irst several sec- stacked-in-trail formation: the lead airplane lowest, followed by
onds of January 19, 2017. The timing seemed so arbitrary that I the second airplane a little way back and slightly higher, followed
asked about the reasoning behind it. My question was amateur- by the tail airplane in the same basic geometry. With the seats
ish, and the pilot did not appreciate it. “I was not privy to those raised high, visibility from the cockpits was good. The seats were
discussions,” he said. “I just go when they tell me to go.” extremely comfortable, and part of an elaborate ejection system.
The B-2s were going to Libya. The most expensive and capa- Crews are required to wear helmets and masks during phases
ble tool in the Air Force arsenal had just been deployed against of light when ejection might be required— on takeof, landing,
a group of ighters in the desert, asleep in scattered locations and aerial refueling, and over hostile territory. For now the pilots
across two camps. The plan was for the B-2s to ly 6,000 miles removed the gear and put on Bose headsets. The ride was smooth
and drop a 500-pound bomb on every one of those ighters. and above the weather, under winter stars and a waning moon.
Their course passed south of Chicago, north of New York, and
across New England. Traic was light. The commander of the
lead airplane was a slightly built captain in his early 30s with a
wife and an infant daughter at home. He probably should have
taken the opportunity to unstrap from his seat and stretch out in
the back of the cockpit. The space there is occupied by a toilet, a
microwave oven, and typically a couple of Styrofoam coolers con-
taining food the pilots pack for themselves. It allows just enough
room for an average-size man to lie down. Managing sleep on
long-duration lights is a crucial part of the job. Some crews bring
a cot for the purpose, and others roll out a camping pad. For this
THE PREPARATIONS light, the commander didn’t even try.
HAD BEEN HUSHED: I’ll call him Scatter. He was lying his irst combat mission. He
FEW PEOPLE ON THE had been preparing for it for 10 years. I can say this much about
BASE, EVEN AMONG him: He grew up in Pittsburgh, graduated from high school in 2003,
THOSE ASSEMBLING and went to college in North Dakota to get a degree in aviation. He
AND LOADING wanted to be an airline pilot. He had a cousin who had been an
Army tank commander in Kosovo. His cousin said, “Hey, man, you
THE BOMBS, KNEW
should check out the military. I think you’d be good at it.” Scatter
THAT THIS WAS
joined the ROTC, enjoyed it, and received his Air Force commis-
SOMETHING OTHER sion upon graduation, in 2007. By then he had several commercial-
THAN A TRAINING RUN. pilot licenses. The Air Force sent him to pilot training in Texas for
two years and assigned him to ly B-52s out of Louisiana. He lew
B-52s for the next three years, accumulating 900 hours of light
time. In 2013 he transferred to the B-2, which he called a pretty
cool airplane, the varsity bomber, and one that, unlike the old-
fashioned, overcrewed B-52, involves its pilots fully in all aspects
of the light. There was a negative to the move as well: Because
Whiteman had more than 100 B-2 pilots, and because 100 hours
of maintenance were required for every hour of light, time at the
controls was extremely limited—no more than 100 hours a year—
and it could be a struggle to meet the minimum combat-readiness
requirement of two flights a month. So Scatter, who had just
emerged from intensive training at the Air Force Weapons School,
II. considered himself lucky to have met the minimum, and then to
INTO THE have been chosen to command the lead ship that night. He was up
NIGHT past his bedtime, but not inclined to doze of.
Over Maine, in the darkness, the planes joined up with four
B-2 pilots make ighter pilots look like dandies. Their mission KC-135 tankers—one to fuel each of the three B-2s, and a spare to
requires them to ly straight and level, and to live the same way. provide redundancy. The KC-135 is a four-engine jet, a derivative
What passes for jauntiness among them is the use of the word jet of the old Boeing 707. It carries a crew of three or four. These had
for the airplane and gas for the fuel. Sometimes they call them- lown to the intercept from bases as far away as California. Scatter
selves drivers. They give one another nicknames. But that’s as led his light into a modest descent, to altitudes where the heavily
cute as it gets. laden B-2s would have more thrust available for maneuvering.
The three jets that took of last January each weighed 336,500 The formation then split apart as each airplane approached its
pounds and carried more than 129,500 pounds of gas—enough, assigned tanker from behind and below. Aerial refueling is the
for instance, for them to get from Missouri to Maine and back most challenging piece of lying that B-2 pilots face. It is accom-
without aerial refueling. Immediately after takeof, the drivers plished entirely by hand, with the autopilot of, in all weather
retracted the landing gear and switched on the autopilot; the three conditions, sometimes with both airplanes blacked out. It
airplanes turned eastward and climbed at a gentle 3,000 feet a requires the B-2 to be held in an unusually restrictive position in

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 47
relation to the tanker, and speciically to the boom that delivers convoy in which he happened to be leeing. Rebels captured and
fuel through a door located on the top of the bomber, aft of the killed him. By then, ighting and air strikes had nearly destroyed
cockpit and out of sight. Whoever came up with that design did Sirte. The long-sufering residents began rebuilding under the
not have pilots’ needs much in mind. When I mentioned this to precarious protection of a militia with Islamist ties, while the rest
Scatter, he shrugged it of. He said, “The airplane is very much of Libya descended into a welter of factions aspiring to national
built to go into combat and be low-observable. It is not built to power. In 2014, soon after the Islamic State gained ground in
make it easy on us. For us to ly in weather or even for us to ly Syria and Iraq, Libyan militants began declaring their allegiance
in a national airspace system, I can’t even just tell my airplane to its leader, Abu Bakr al-Baghdadi, and his cause. By early 2015
to go to a ive-letter ix”—the worldwide navigational waypoints they were able to iniltrate Sirte, shift the aspirations of the mili-
embedded in the databases of other aircraft—“I have to enter the tia members in place, and declare the town part of the blessed
lat./long., because the airplane is designed to go bomb a country. caliphate. Militants from outside Libya joined them, until their
It’s not designed to ly into LAX.” numbers in the city swelled to about 2,000. They imposed their

FOR THE HANDFUL OF SURVIVORS, RUNNING FRANTIC-


ALLY, THE ORDEAL WAS NOT YET OVER. WITH THEIR
HELLFIRE MISSILES , REAPER DRONES MOVED IN AND
BEGAN PICKING OFF ANYONE TRYING TO GET AWAY.

The B-2 is designed to fly into the maelstrom when Los version of Islamic law, leveled usurious taxes, and committed
Angeles is burning and GPS signals have been jammed. It is various atrocities. They made propaganda videos of their heroics
made to defeat the world’s most advanced air-defense sys- and posted them online.
tems. In addition to its conventional navigational capabilities, In Washington this was seen as America’s problem. Ever
it has autonomous systems that operate independently from since the disintegration of the Qaddafi regime, the Obama
any ground- or space-based transmitters. The primary one is administration had been struggling to invent a new Libyan
an inertial unit that slowly drifts, as inertial units do, but can state—one not quite to its taste, but complete at least with a
be recalibrated in light by using a stellar navigation system single capital and government. The solution settled on by the
that observes stars day and night, or alternatively by using the international community was an assembly that was founded in
airplane’s synthetic-aperture radar to pick out ground features late 2015 as the Government of National Accord and declared
at thousands of locations worldwide, which are known to an air- by foreign diplomats to be the sole legitimate executive author-
borne database. It is impressive what you can persuade yourself ity in Libya, even though it could not control the capital and
to think you need once a supplier like Northrop perceives that much of Libya violently opposed it.
there is no limit to cost. In 2016, militia forces from the city of Misrata, apparently
But ighting a nuclear war is getting ahead of things. The seeking legitimacy, declared their allegiance to the Govern-
intended target now was a fractured country with no air defenses ment of National Accord and with 6,000 ighters advanced to
at a time when GPS satellites were functioning unimpeded, and retake Sirte from ISIS. They arrived in May and got bogged down
indeed would be guiding the bombs. The refueling took 15 min- in house-to-house ighting against die-hard militants holding
utes. When it was over, the tanker crews went of to land some- strong positions. Overseeing the battle from afar was the U.S.
where local and get some rest. Dawn was approaching. The B-2s Africa Command, one of the Pentagon’s 10 joint-combat groups,
climbed back to cruising altitude, and their crews ran a inal based in Stuttgart, Germany. Africa Command had a few Special
operational check. It showed that every system and weapon in Forces on the ground to observe and advise, as well as drones
all three airplanes was functioning correctly. Scatter cleared the over the city and a wealth of other resources as needed. The
third B-2 to return to Missouri, and he led the light, now of two, drones were lown remotely by pilots in the United States. Early
into the irst Atlantic crossing of his bombing career. in the ight they were given authority to ire on individually speci-
ied targets. This seems to have had little efect. In July 2016 a
new commanding oicer arrived in Stuttgart, a Marine Corps
general named Thomas D. Waldhauser. In August he ordered
III. an increase in air strikes, with carrier-based Marine Corps Har-
SQUIRTERS rier jets and helicopter gunships joining in. Over the following
few months, the U.S. carried out nearly 500 strikes. That may
seem like a lot, but these were pinpoint hits, and actually an exer-
The origin of the mission was the NATO intervention in Libya cise in restraint. President Obama had insisted on the need to
in March 2011, during the Arab Spring—an initiative that Presi- avoid civilian casualties. Speaking about Africa Command, an
dent Barack Obama later admitted was one of the worst of his observer at the Pentagon explained to me that it had faced the
administration. The intervention meant that the United States standard frustration of counterinsurgency campaigns: “They
would be married to the confusion that followed the downfall of didn’t know who was who in the zoo.” Gradually, however, ISIS
the Libyan dictator Muammar Qaddai. Qaddai came from the was worn down and defeated.
coastal town of Sirte, halfway between Tripoli and Benghazi. In Of the original 2,000 ISIS fighters, many had died, but a
strongman style, he had spent decades building it into a monu- good number had managed to slip away, even though check-
ment to himself. After he was driven from Tripoli, he retreated to points had been set up around Sirte. Africa Command knew it.
Sirte, and for a few months made a stand, until rebels overran the In the Air Force, escapees are called “squirters” because, rather
place. On October 20, 2011, an American drone strike stopped a than being crushed, they squirt out from the pressure of strikes.

48 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
In Sirte, some squirters turned around and launched attacks launching an attack against a modern military adversary. But the
from the rear. Others squirted into the cities, where they dis- high cost of the mission was perhaps an attraction by bureau-
appeared. One relatively small group—no more than 100 men— cratic if not military logic—you may lose money if you don’t
squirted into the desert about 30 miles southwest of town. They spend it—or the B-2s might have just needed some work to do.
established two camps, about 10 miles apart. The Pentagon The Air Force says simply that after a formal process of consid-
would later state that they were planning attacks on Europe. eration, the B-2 was deemed the appropriate platform.
On the evidence, they were also unusually inefectual people. Here’s how the process worked: Waldhauser wanted the B-2.
Despite the known presence of American drones overhead, they While his request was being studied at the White House, the Joint
had chosen to congregate in the open desert, away from any Chiefs of Staf formally asked Strategic Command about the avail-
protections ofered by the presence of civilians. Their incompe- ability of the assets. Stratcom is headquartered at Ofutt Air Force
tence was Waldhauser’s liberation. For once there was no need Base, in Nebraska, where the B-29s that demolished Hiroshima
to know who was who in the zoo. and Nagasaki—the Enola Gay and the Bockscar—were built, in

1944. Stratcom occupies a building named after Curtis LeMay. It


IV. passed word of a possible B-2 strike to one of its subordinate units,
Air Force Global Strike Command, which is headquartered at
“READY TO Barksdale Air Force Base, in Louisiana. Global Strike Command
DO THIS?” controls all of the Air Force’s heavy bombers and intercontinental
ballistic missiles. It contacted the 509th Bomb Wing, home to the
Early last January, Waldhauser concluded that taking action was B-2s at Whiteman. All the way down through the chains of com-
a matter of grave national importance. Cost was apparently not a mand, the only thing anyone asked was “Are your guys available
factor. The objective was to kill every man in the two ISIS camps and ready to do this?” Stupid question. The 509th is the direct
without placing Americans at signiicant risk. The use of Special descendant of a bomber group formed in 1944 for the purpose of
Forces was unlikely to achieve either goal. Only air strikes would dropping nuclear weapons on Japan. It was commanded last Janu-
do. Now there was a choice to be made among weapons plat- ary by the grandson of its commander then. Hundreds of military
forms: Navy cruise missiles; Air Force drones; Navy, Air Force, or personnel at Whiteman—pilots and ground crews alike—had been
Marine Corps ighter-bombers; Army or Marine Corps helicopter training for years, and were not just ready but straining to go.
gunships; Air Force strategic bombers; or some combination of Preparations for the air strike began immediately, more
these options. In theory, the decision-making process should than a week before the launch. The planning was shrouded in
have been clean. Waldhauser would have come up with several secrecy, most of it taking place in a secure basement. The room’s
courses of action as well as a recommendation, and he would screens displayed classiied information from the military’s vast
have run the package through the Joint Chiefs of Staf to the sec- command, control, and intelligence systems, and were closely
retary of defense, who would have taken it across the Potomac linked to a team at Global Strike Command in Louisiana, which
to the National Security Council, and ultimately to the president was making the targeting decisions. The feeds included video of
for a decision. The president could have responded with a simple the intended targets, streaming in from the armed drones that
conirmation of the recommended plan and an order to proceed— were maintaining a round-the-clock watch overhead. The light
leaving the operational details to the military. crews and B-2s—both primary and standby—were selected. On
In this case, after the initial presentation was made, long Wednesday evening, January 11, six days before the launch, the
discussions ensued in the White House. As usual, the weap- munitions squadron received orders to assemble several hundred
ons had constituencies at the Pentagon. The Navy in particular bombs. The assembly involved 3,500 pieces and 78,000 pounds
made a case for its cruise missiles, at more than $1 million each, of explosives. The task, starting Thursday morning at 5 a.m.,
because they would allow the killing to be done from ofshore. The was carried out in 30 hours by more than 100 people working
problem was that the targets, though clustered around the two 12-hour shifts. The senior sergeant in charge knew that this
camps, did not dwell in structures that could be hit, and tended was for real and not just another exercise. Many of the people
to spend their days and nights widely dispersed. A cruise-missile doing the work were young recruits, new to the Air Force, but they
strike would likely allow many to escape. In the end, the idea of got the job done. The sergeant said, “Trust the process. Trust the
using Air Force heavy bombers prevailed because of their ability training.” He himself seemed young to me when I met him, but he
to deliver dozens of self-steering, individually targeted bombs; had been in the Air Force for 18 years, and was planning to retire in
then to linger in the vicinity, waiting for surveillance assess- another two. He loved the Air Force for the lifestyle it had aforded
ments from the drones; and if necessary to deliver more bombs. him. He did not have to go into the ield as he would have if he had
The Air Force has three types of heavy bombers, any of which joined the Army. About the ield, he said, “They call it ‘the suck.’ ”
could have done the job. The choice of the B-2 was surprising Compared with any Army outpost, Whiteman is Pleasantville.
because it is by far the most expensive airplane to ly and main- The sergeant was proud of his team. Thinking back on the efort,
tain, and Libya post-Qaddai had no air defenses that might he told me, “They were in Missouri— central Missouri—ighting
require a stealth capability to penetrate. Bombing ignorant gun- terrorists all the way from here. They got to see what they had
men camped out in a desert of a non-country is a far cry from raised their hands for, what they had signed up to do.”

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 49
seemed surreal. The pilots crossed the coastline, entered their
V. launch acceptability regions about 10 miles from their targets,
opened their bomb-bay doors exactly on schedule, and released
BENGHAZI ON their weapons as planned. Scatter released 62 of his 80, and the
THE LEFT other aircraft commander released 23. That left 75 bombs in the
airplanes should another attack be needed. The B-2s did not
In advance of the mission, the pilots were told to go home for a lurch when the bombs were released. A slight vibration could
mandatory crew rest of three days, but they all had wives and be felt when the bomb-bay doors opened, but that was all. The
young children, and that weekend there was an ice storm. Fatigue doors were open only for about 30 seconds. From above, Scatter
was of no concern to Scatter when he got the call on Monday after- saw the impacts as orange glows through an undercast of cloud.
noon to report for duty. He drove to the base in his paid-of 2002 The efect was oddly beautiful.
Dodge Ram truck. The light across the Atlantic was smooth. At
35,000 feet the skies were clear. To avoid the political complica-
tions of overlying countries on such a raid, the route to the Medi-
terranean lay farther south than the shortest great-circle course. VI.
The pilots were in contact with oceanic air traic control. Commu- RIPPED APART
nication between military aircraft and controllers is routine, and
necessary for safety in ordinary airspace; the controllers would
have assumed that the B-2s were on a training mission. It looked different on the ground. The ISIS camps consisted
The pilots were in contact as well with their Air Force mission of a few small structures with walled dirt yards—too small to
controller in Louisiana. And they were busy. A quarter of their serve as living quarters, but useful for the storage of weapons.
bombs had been programmed before takeof to hit any vehicles They stood along a rarely traveled track, in terrain that for all its
or physical structures, but the rest of the bombs had to be pro- desolation allowed for a scattering of bushes and scrubby trees.
grammed in light based on the latest information coming from For several weeks, the Air Force drones had watched the scene
the drones—essentially, the precise geographic coordinates of from above, establishing detailed proiles known as “patterns
individual ISIS ighters who could be seen settling in for the night. of life,” which mapped out daily activities, mealtimes, and the
That information began to low to the airplanes two hours shy outdoor locations to which individuals dispersed in the darkness
of their reaching the Mediterranean. The programming-and-
conirmation process took hours. Scatter told me, “It’s not like
Steve Jobs designed the interface.”
Night came quickly after a short day. Once they passed into
the Mediterranean, the pilots used their radar to ind three tank-
ers that had come from Germany to meet them for their second
refueling, and to map some thunderstorms that were active in
the area at the time. Because of its composite structure, the B-2 is
particularly vulnerable to static discharges and lightning strikes,
and is required to stay 40 miles away from thunderstorms—twice
as far as other airplanes.
During the refueling and afterward, the B-2 pilots spoke with
European air traic control. The skies cleared. Approximately
250 miles north of the Libyan coastline, the pilots turned south,
switched of their transponders, and disappeared from air-traic-
control radar. They had now been lying for 15 hours. Still of-
shore, they went into a holding pattern that had been planned as
a cushion to allow them to get the timing just right. It was nearly
midnight Zulu Time—two in the morning local time. They heard
the mission controller order the drones to clear out to the south,
and authorize them to return immediately after the strike to kill
anyone who survived. The drones were MQ-9 Reapers armed
with laser-guided supersonic Hellire missiles. Their pilots were
sitting in front of control panels back in the United States. Scatter
was surprised by the blanket authorization to ire. He had never
heard that one before.
The B-2s left the holding pattern and moved toward the
camps at 35,000 feet, on autopilot, doing 480 miles an hour.
They spread into a rough line-abreast formation, each headed
for a virtual hockey puck in the sky, a “launch acceptability re-
gion,” where all they had to do was release the bombs, which
would guide themselves to their targets. As the B-2s approached
the coast, Scatter could see the lights of Misrata on the right and
Benghazi on the left. For some reason he thought of vacation-
ing with his family in Europe. He told me that the view of Libya

50 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
to sleep—typically by certain bushes or trees. The images in day- picking of anyone spotted trying to get away. Killing with Hell-
light were high resolution and in full color. The images at night ires is very diferent from killing with GPS-guided bombs. It
were of the ghostly night-vision kind. There were no women or requires the Reaper crews to get personal, laying a laser device
children. The combatants spent their days talking and some- on magniied images of each individual victim and then watch-
times handling small arms, or perhaps explosives. They had ing the missile as it strikes. A Hellire missile has a blast radius
some Japanese pickup trucks, which they tried to hide under of 50 feet and a “wounding radius” of up to 300 feet. It could
camoulaged tarpaulins. kill hundreds of people as easily as it could kill one. Once the
It was a chilly night on the ground, with temperatures in the Hellires had mopped up, the only sound in the desert was the
40s. From my own experience in that desert, I imagine that the hum of the Reapers’ engines.
ISIS ighters were sleeping fully clothed and wrapped in blankets,
and perhaps were nestled for comfort in undulations of the ter-
rain. If any were awake, they would not have heard the jets high
overhead; the only forewarning of the attack would have been a VII.
brief sound of rushing air before the irst bomb hit. CRICKETS
For the next 30 seconds, the bombs came at them with
demonic accuracy. Each 500-pound bomb was set to deto-
nate just above its target for maximum lethality, operating After releasing their bombs, the B-2s banked gently to the left
more through overpressure than fragmentation. The resulting and retreated to a holding position safely offshore. The ride
vacuum condition sucks air from the lungs while the shock wave was smooth, pressurized, and comfortable. Plans called for
pulverizes bone and ruptures or liqueies the internal organs of the bombers to stay quietly on station for another six hours in
anyone within about 50 yards. That is how most of the ISIS ight- case their services were needed again. Scatter explained it this
ers died: hugging the earth to no avail as their innards turned to way: “You’ve got a desert with people camped out in the middle
mush and the night was ripped apart by the explosions. of nowhere. You drop a bomb on them; it’s like kicking an ant-
For the handful of survivors, the ordeal was not yet over. The hill. They may run. They may need a reattack.” Scatter listened
dust had hardly settled when the Reaper drones moved back in, on the mission-control frequency over the next hour, until the
looking for squirters. Figures could be seen in real time, run- Reaper crews inished up. It was obvious, even without a formal
ning frantically. With their Hellire missiles, the Reapers began battle-damage assessment, that the toll on the ground was heavy.
Eventually the mission controller asked for any signs of life, and
the Reaper crews answered in the negative. Scatter said, “Then
it was just, like, crickets on the radio.”
Not long after, the B-2s got the clearance to return to Missouri.
They refueled over the Mediterranean south of France. Then
they went over the Strait of Gibraltar and out across the Atlan-
tic. The return trip seemed slow, as return trips do. Scatter spent
THE MOST much of the time writing a formal mission report. He left his seat,
stretched out on the loor in the back of the cockpit, and took a
EXPENSIVE
two-hour nap. His pilot did the same. In the other B-2, the aircraft
TOOL IN commander took an oicially issued “go pill” to stay alert. He got
THE AIR out of his seat, stripped down to nothing, sponged himself with
FORCE camping towelettes, washed his face, brushed his teeth, put on a
ARSENAL fresh light suit, and made sure that his hair looked good. He told
HAD BEEN me a lot of guys do the same thing, and it refreshes them. I took it
DEPLOYED as further evidence that the Air Force is not the Army.
AGAINST They refueled again over Maine, with the same crews who
A GROUP had refueled them on the way out. When they got back to Mis-
OF FIGHTERS souri, the weather was low, and they had to shoot an approach to
ASLEEP IN 200 feet of the ground before they could make out the runway
at Whiteman. They had been 33 hours in the air. As the second
THE DESERT.
B-2 came in, the control tower canceled its landing clearance
WHEN THE because of a coyote on the runway. The pilot was too tired to be
CREWS GOT bothered. He called back, “Negative. I’m landing this jet,” and
BACK TO the coyote obliged by getting out of the way. When they taxied
MISSOURI, to the ramp and shut down their engines, they were surprised to
THEY FOUND ind a ilm crew waiting, along with half the colonels on the base.
A MEAL OF A meal of steak and eggs and beer had been laid out for them.
STEAK AND Scatter got home that afternoon. He had been up since for-
EGGS AND ever, but he’d have to stay awake a little while longer. His wife put
BEER LAID the baby in his arms. She had an errand to run.
OUT FOR THEM.
William Langewiesche, a former national correspondent for
The Atlantic and a professional pilot, has written about subjects
including aviation, national security, and North Africa.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 51
THE SEARCH
FOR THE
ELIXIR THAT
TURNS GOOD
TEAMS INTO
GREAT ONES
N THE FINAL REGUL AR- SEA S ON GAME for the 1977

I Los Angeles Dodgers, Dusty Baker hit a home run, giving


him 30 for the season and making him the fourth Dodger
to reach that milestone that year, a Major League Baseball
record. As Baker rounded third, a rookie who had recently
entered the game, Glenn Burke, approached the plate from the
on-deck circle and, seized by joy, raised his hand high above
his head. Baker was taken aback by the gesture and, in a mix
of celebration and confusion, decided to smack Burke’s hand.
Their high ive was clumsy, but then again it had every right to
be: Reportedly, it was the irst one ever.
Baseball has always been a strange mix of social and solo.
In American fashion, the game stresses the collective, but
demands that you play for yourself. Despite all the intimacy of
the sport’s language—crowding the plate, touching base—its play
is quite lonely. Other sports require a tacit harmony between
players—setting a pick for a teammate, blocking for someone
10 yards behind. In contrast, a baseball hitter stands in the
solitary coninement of the batter’s box, facing a pitcher on the
desert island of the mound. The players on the defense align
themselves, except for the occasional shift, to be as far from one
another as the limits of the ability to recuperate lost space per-
mit. Defensive errors are unfailingly—and oicially—attributed

52 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
FINDING THE
FORMUL A FOR
TE AM
CHEMISTRY
BY BEN ROW EN

I L LU S T R AT I O N S BY I S R A E L G . VA R G A S

T H E AT L A N T I C J U LY/AU G U SY
T 2 0 1 8 53
to individual players. The rule book, irrespective of out-of-play Pence spoke up after the team’s manager, Bruce Bochy, concluded
butt slaps and handshakes, does not sanction contact. his pregame talk. No one had expected remarks from a player, let
And yet somehow, despite this loneliness—or perhaps because alone a newish one. And no one expected such intensity: Pence
of it—the sport is now at the center of an intensifying search for made feverish eye contact, and allegedly spoke with the passion
the nebulous, nearly mythical quality of team chemistry. In the of a revivalist preacher about the need for the team to reawaken.
popular conception, almost all great teams are alike in possessing It seems to have worked. The Giants, of course, did win that
it. But what exactly the quality is, and just how strongly it governs night, and they won the next two games as well, and then they
success, remains unclear. The ’77 Dodgers possessed some of it, won the next two series to become the champs. You could argue
but apparently not enough: After storming into the World Series, that Pence’s motivational speech, and its taken-to-heart recep-
they lost to a feuding New York Yankees squad that had been cyni- tion, proves the team had a superior clubhouse atmosphere.
cally described as “the best team money could buy.” Alternatively, you could note that the Giants didn’t play par-
In 2014, Harvard Business Review deemed chemistry the “Holy ticularly well in the game right after the speech—they got just
Grail” of performance analytics, the statistical discipline that one hit in the irst nine innings. Grant Brisbee, who used to run
irst swept the sport wholesale some 20 years ago. The choice of McCovey Chronicles, a Giants blog, says that luck almost cer-
image was telling; the Grail, of course, remains elusive. Nonethe- tainly gave them the win. With two outs in the top of the 10th
less, a number of research groups are now taking a bet that they inning and two runners on base, Joaquin Arias, a scrap-heap
can pin down chemistry, through advanced math or anthropologi- pickup who had entered the game earlier to pinch-hit, knocked a
cal forays into the clubhouse. Some researchers, believing that ground ball toward Scott Rolen, the Cincinnati Reds’ third base-
team chemistry may emerge from literal chemistry, are collecting man. Rolen is the ifth-best defender ever at third base according
and analyzing biometrics: testosterone levels, hormonal states. to one analytics site, Fangraphs, and in the top 20 of all time by
Whatever the approach, much of the research is led by traditional stats such as ielding percentage. And yet, as the ball
outsiders— economists and organizational-development scholars approached Rolen, it took an in-between hop and bobbled of his
who seek to use baseball, as it is frequently used, to better
understand the American workforce. Because individual
success or failure is so easy to isolate in baseball, the sport
itself is also easy to study; individual performance can be
related clearly to team success. “Moneyball” is already
used to explain changes in everything from company
SOME
hiring to restaurant operations. Now, it is hoped, solving RESEARCHERS
baseball chemistry might advance corporate teamwork
where Myers-Briggs tests and other methods have failed. BELIEVE TEAM
“Baseball is a team game,” Pete Rose, the former
player and manager, once said. “But nine men who reach
CHEMISTRY
their individual goals make a nice team.” Surely that’s MAY EMERGE
too simple. A good team helps those men reach their
individual goals, and harnesses them to something
FROM LITERAL
larger. The question is how. CHEMISTRY:
N IT S T YPICAL INVOCATION, chemistry is a cop- TESTOSTERONE
I out—an after-the-fact explanation of why a team won,
especially against the odds. It lets us avoid uncomfort-
able truths: that baseball, like the workforce, is not always
LEVELS,
HORMONAL
a meritocracy; that mediocre teams can capitalize on luck
to beat very good ones; that the sport can be cosmically STATES.
unjust. In the postgame twilight, chemistry coalesces as
a narrative—the “It’s not you, it’s me” of baseball heart-
break. It rings hollow, but is not provably false.
The 2012 San Francisco Giants were widely lauded by sports mitt. Buster Posey scored on the error, giving the Giants a lead
bufs and journalists alike for their extraordinary chemistry, they wouldn’t relinquish. One lucky bounce might have been
following their improbable World Series victory. The team responsible for San Francisco’s championship.
made it through the three rounds of the playofs, as the under- That’s not to say the team lacked chemistry. (Though the
dog each time, and twice fought back from a two-game deicit, Giants missed the playofs altogether in 2013, they made another
on the brink of elimination. improbable run to the championship in 2014; they’d also won in
Barry Zito, then a declining Giants pitcher who miraculously 2010.) But chemistry has a way of getting entangled with con-
outdueled opposing pitcher and reigning American League MVP current explanations. “It’s a lot easier for us to process a narra-
Justin Verlander in a game that had been billed as “one of the great tive,” Brisbee told me, “rather than ‘This guy was standing two
mismatches of World Series history,” told me recently about the inches to his left, and that changed the whole postseason.’ ”
team’s postseason turning point, which he ofered as proof of its
chemistry. It was a speech, he said, made early in the playofs by HERE IS NO I IN TE AM, but there is in statistics. Baseball,
Hunter Pence, a mid-season acquisition. The team was down two
games to none in its opening-round, best-of-ive playof series, and
would have to win the next three games straight—all on the road.
T like no other sport, has stats that make a special snowlake
out of every player. During the moneyball era of the early
2000s, these stats proliferated, and their relative importance

54 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
was hotly debated, as analysts tried to ind clearer links between full season as a starter during his 15-year career, which ended in
individual performance and team success. But for the most part, 2016. He nevertheless won championships as a backup catcher
to the analytics community of that era, chemistry was not worth with both the Boston Red Sox and the Chicago Cubs, and wrote
investigating. Some thought it couldn’t be measured or, worse, a memoir, with Don Yaeger, a sports journalist, called Teammate.
was total “bullshit,” as the analyst Rob Neyer once put it. Billy Wherever he went, as the economists conirmed, teams seemed
Beane, the Oakland Athletics’ general manager who became syn- to play better than their individual player statistics suggested
onymous with the moneyball revolution, believed that chemistry they should have.
existed, but that it was brought about by winning, not the other I spoke with Ross during Major League Baseball’s Winter Meet-
way around. ings in December. He was advising the Cubs, and had some time
Still, front oices did consider chemistry, as any hiring body on his hands. (The meetings, typically a frenzy of free-agent sign-
would. Zito, who played for the Athletics before he joined the ings, were of to a plodding start; the only news was that the canon-
Giants, told me that Beane “had a good grip of how signings would ical team-chemistry guy, the ex-Yankee and now Miami Marlins
afect the clubhouse.” The team, Zito said, was highly compatible, co-owner Derek Jeter, was spatting with his team’s star players.)
and would often gather for dinners. In a general sense, Ross told me, chemistry isn’t hard to snif out—
Meanwhile, as the moneyball movement grew, its acolytes “It’s like walking into a bar and getting a vibe.” But what specii-
began to think they might be missing something. Performance cally it’s made of, and how it can be measured, is a harder question.
analytics do not predict team success with anything close to cer- Ross said that chemistry is “deinitely something that can be
tainty. PECOTA, one of the top stats-based projection systems, was learned.” The foreword to his memoir, written by Theo Epstein,
of by an average of nine wins per team in its best season, accord- the Cubs’ president of baseball operations and a former Red Sox
ing to Neil Paine of FiveThirtyEight. Luck and injuries play a large general manager, explicitly notes that when Epstein was inter-
part in statistics falling short. Even so, researchers and writers are ested in acquiring Ross in August 2008 for the Red Sox, he heard
coming to think, there’s ample space for chemistry to play a role. reports that the catcher was “not a good teammate” in Cincin-
nati. Ross attributes this old reputation to a time, early in his
career, when he barged into the team manager’s oice to com-
plain that he wasn’t starting.
In the book, Ross writes about learning to better communicate
with players over time, and highlights one moment in 2016 when
the Cubs’ rookie catcher, Willson Contreras, signaled for an of-
speed pitch to try to fool a hitter ahead in the count, instead of
directing the pitcher to pitch around him to face a better matchup.
Ross noticed the mistake from the bench as he read the sign from
Contreras, but he waited a few innings before addressing it. If you
call out mistakes immediately after the fact, he notes, you catch
people at their most defensive, and if you address every one of
them, you can lose goodwill.
The analysis by the economists echoes some of what Ross
told me. They found that players do seem to “learn” to create
chemistry—intangible contributions to team success tend to rise
with age and, for the most part, only become appreciable in play-
ers’ mid-to-late 30s, which is very late in a player’s career. (Good-
chemistry players may also just stick around the league longer.) In
many cases, the economists found, stars make the largest intan-
gible contributions, just as they make the largest tangible ones—
Mike Trout, the best current player by performance metrics, is also
the best by raw chemistry rating. By contrast, many “clubhouse
cancers”—players who worsen a team’s chemistry—began their
career with seeming star potential, but never really panned out.
Two economists at the Federal Reserve Bank of Chicago and Perhaps the stars are better able to inluence a clubhouse by
one from Indiana University recently attempted to locate team dint of their on-ield prowess (or, critics of the Fed paper may
chemistry by inding places where existing performance metrics note, perhaps they simply cover for other players’ poor perfor-
fall short. In a paper titled “In Search of David Ross,” presented mance on the field); maybe the never-turned-into-stars leak
at the 2017 MIT Sloan Sports Analytics Conference, R. Andrew toxic embitterment. This is speculation. The Fed economists
Butters, Scott A. Brave, and Kevin Roberts looked at teams whose weren’t studying clubhouse behavior, nor were they seeking to
win/loss record difered greatly from what would be predicted by understand the particular alchemy by which chemistry is cre-
the sum of individual performance. Studying more than 15 sea- ated. Other analysts, however, are doing just that. Which brings
sons’ worth of data, they identiied the speciic players who were us back to the high ive.
on teams that repeatedly overperformed. These players, the
economists hypothesized, create chemistry—they have shown A S T Y E A R , according to Wall Street Journal reports, a
repeated ability to elevate their team above the sum of its parts.
David Ross, the paper’s namesake, is “the epitome of where
advanced metrics and player intangibles are at odds,” the
L research group was granted access to the San Francisco
Giants’ minor-league ailiate in San Jose, where it installed
cameras with the goal of monitoring associations between dug-
authors wrote. Ross is a retired journeyman who played only one out interactions—high fives, back pats—and team success. A

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 55
similar efort is under way in the major leagues, where Dacher Bezrukova, a professor at the University at Bufalo School of
Keltner and Hooria Jazaieri, psychologists at UC Berkeley, are Management, looked at the demographic breakdowns of all 30
conducting research with the goal of inding associations between MLB teams over ive seasons, analyzing age, race, nationality,
the supposed subtle physical tells of chemistry and team success. tenure, and salary, on the theory that while diversity was neces-
The entire approach might seem absurd. Can a high ive or ist sary for success, teams with players who were isolated—those
bump really create—or even stand in for—camaraderie, in all its without any or many demographic peers—would develop “fault-
complexity? Then again, as Barry Zito told me, “guys that don’t lines,” or breaks in chemistry that might be exposed and exacer-
respect each other won’t go out of their way to congratulate each bated when the team struggled. Her model shows that these fault
other after a big moment.” And a celebratory touch can demon- lines could be mitigated if players in the underrepresented group
strate a deeper level of acceptance and intimacy. Notably, Glenn happened to be clustered together in similar roles (Latino play-
Burke, the rookie who ofered a raised hand to Dusty Baker after ers sitting together in the bull pen as relief pitchers, for example).
the latter’s historic home run, was out of the Over the course of a season, she found, a team
closet to his teammates by the time of that with fewer fault lines will win more games, all
game back in 1977, the irst openly gay player
in American professional sports. That moment
MANY “CLUBHOUSE else being equal.
Bezrukova’s work has been criticized for
of contact, in retrospect, helps undercut regres- CANCERS”— being demographically reductive. Its conclu-
sive but still prevalent assumptions about base- sions are uncomfortably similar to the thought
ball’s culture. PLAYERS WHO processes of general managers who balked
Research is still in progress, but David
Ross told me he’s dubious. He said chemistry
QUANTIFIABLY at integration before Branch Rickey signed
Jackie Robinson, for instance. But players
is “deinitely not about high ives and rah-rah WORSEN A TEAM’S seem to agree that being isolated makes the
stuff; it’s about respect.” Nonetheless, his
book seems to place a high premium on the
CHEMISTRY— game tougher to play. Johnny Cueto, a pitcher
on the 2017 Giants, which inished the season
gesture. Ross recounts barking at the Atlanta BEGAN THEIR 64–98, has spoken about feeling alone as the
Braves’ irst-string catcher, Brian McCann, after squad’s only Dominican pitcher for most of
McCann once forgot to ofer him a high ive, as CAREER WITH the season: “When I was with Kansas City, it
was their usual custom, when Ross returned
to the dugout after a half inning of defensive
SEEMING STAR was a team, I think; it was a very happy bunch
because we had a lot of players” from the
work. He also writes about creating a new high POTENTIAL, BUT Dominican Republic. “But here, it’s diferent.”
ive to celebrate home runs, which he calls the In 2014, ESPN the Magazine used a
“cock bump”—the two players square up to each NEVER REALLY model designed by Bezru kova and Ches-
other and thrust, bumping their cups. And he
has strong praise for other ritualistic acts, most
PANNED OUT. ter Spell, a Rutgers University business
professor, in its preseason MLB predictions,
notably the naked dance his Cubs teammate selecting both the Giants and the Royals—
Anthony Rizzo did, to the musical accompaniment of the theme the eventual World Series participants—as two of the strongest
from Rocky, before each of the inal three games of the 2016 World teams on the chemistry metric. This remains, to date, the stron-
Series. It kept the team loose, he said, despite being on the brink of gest evidence that chemistry research can have predictive value.
elimination—and the Cubs miraculously won all three.
Russell Carleton, a writer for Baseball Prospectus, has found HATEVER INSIGHTS INTO CHEMISTRY the study of
evidence that chemistry can be cultivated in the long term
through careful organizational management—one analysis of
his, for example, reveals that having less roster turnover from
W baseball eventually enables, their application to the game
may be tricky. Understanding chemistry is an interesting
philosophical problem; creating it is a practical one. Research
year to year helps a team slug more home runs. But he also notes has no value if players (or, for that matter, other types of work-
that undigniied rituals, like Rizzo’s dance, can go a long way to ers) won’t buy into its conclusions. “Twenty-something hyper-
creating cohesion more spontaneously. A child psychologist by competitive males aren’t always well known for being in touch
training, Carleton has been a consultant to three Major League with their feelings,” Carleton told me. The study of chemistry
Baseball teams. In 2015, when Ben Lindbergh and Sam Miller— has been hampered by that fact.
baseball geeks and former editors at Baseball Prospectus—were Even so, the turn of the analytics crowd toward intangibles
given control of the Sonoma Stompers, a team 10 levels below the might be welcome in some quarters. Many players have been
majors, they turned to Carleton for guidance on creating chem- resistant to much of the new analytics, charging that they suck all
istry, a skill outside their wheelhouse. In their book, The Only the joy and humanity from the game. When the 2017 Washington
Rule Is It Has to Work, they detail Carleton’s advice: Corporate Nationals, a team highly regarded by the analytics crowd, clinched
icebreakers are ine, but also have a water-balloon ight—or any a postseason berth last September, the outielder Jayson Werth
other activity that would be welcome at a 12-year-old’s birthday touted the team’s superior chemistry, claiming that it was some-
party. (Notably, childish spectacles—holding bufoonish dress- thing the “people upstairs who read books and do math, bullshit
up days, bringing bear cubs to practice—are a core team-building like that,” could not understand.
activity deployed by Joe Maddon, the Cubs’ manager, to keep As it happened, neither the analysts nor Werth had the team
his players energized.) As Carleton likes to say: “The irst rule of right: For the fourth time in four recent playof appearances—on
child psychology is that it applies throughout all of life.” account of something unmeasurable, or just by dumb luck—the
So does high-school psychology, according to other research- Nationals were eliminated in the irst round as the higher seed.
ers who are looking, essentially, at the isolation of individual play-
ers and the development of cliques on diferent teams. Katerina Ben Rowen is an associate editor at Paciic Standard.

56 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
June 24-30, 2018
WHEN
THE
NEXT
PLAGUE
HITS
The epidemics of the early 21st century revealed a world unprepared, even as the risk

Workers at the University


of Nebraska Medical
Center’s biocontainment
unit practicing safe proce-
dure on a mannequin

58 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
| T H E H E A LT H R E P O R T |

of pandemics continues to multiply. Much worse is coming. Is Donald Trump ready?

PHOTOGRAPHS BY JONNO RATTMAN


A
T 6 O’CLOCK IN THE MORNING, shortly after the sun spills
over the horizon, the city of Kikwit doesn’t so much wake up as
ignite. Loud music blares from car radios. Shops ly open along
the main street. Dust-sprayed jeeps and motorcycles zoom east-
ward toward the town’s bustling markets or westward toward
Kinshasa, the Democratic Republic of the Congo’s capital city.
The air starts to heat up, its molecules vibrating with absorbed
energy. So, too, the city.
By late morning, I am away from the bustle, on a quiet,
exposed hilltop some ive miles down a pothole-ridden road. As I
walk, desiccated shrubs crunch underfoot and butterlies lit past.
The only shade is cast by two lines of trees, which mark the edges
of a site where more than 200 people are buried, their bodies
Atlanta, scientists identiied the virus. It took the name Ebola
from a river near Yambuku. And, having been discovered, it
largely vanished for almost 20 years.
In 1995, it reemerged in Kikwit, about 500 miles to the south-
west. The first victim was 35-year-old Gaspard Menga, who
worked in the surrounding forest raising crops and making char-
coal. In Kikongo, the predominant local dialect, his surname
means “blood.” He checked into Kikwit General Hospital in
January and died from what doctors took to be shigellosis—a
diarrheal disease caused by bacteria. It was only in May, after the
simmering outbreak had lared into something disastrous, after
wards had illed with screams and vomit, after graves had illed
with bodies, after Muyembe had arrived on the scene and again
sent samples abroad for testing, that everyone realized Ebola
was back. By the time the epidemic abated, 317 people had been
infected and 245 had died. The horrors of Kikwit, documented
by foreign journalists, catapulted Ebola into international infamy.
Since then, Ebola has returned to the Congo on six more occa-
sions; the most recent outbreak, which began in Bikoro and then
spread to Mbandaka, a provincial capital, is still ongoing at the
time of this writing.
Unlike airborne viruses such as influenza, Ebola spreads
only through contact with infected bodily luids. Even so, it is
capable of incredible devastation, as West Africa learned in 2014,
when, in the largest outbreak to date, more than 28,000 people
were infected and upwards of 11,000 died. Despite the relative
diiculty of transmission, Ebola still shut down health systems,
piled into three mass graves, each about 15 feet wide and 70 feet crushed economies, and fomented fear. With each outbreak, it
long. Nearby, a large blue sign says IN MEMORY OF THE VICTIMS reveals the vulnerabilities in our infrastructure and our psyches
OF THE EBOLA EPIDEMIC IN MAY 1995. The sign is partly obscured that a more contagious pathogen might one day exploit.
by overgrown grass, just as the memory itself has been occluded These include forgetfulness. In the 23 years since 1995, new
by time. The ordeal that Kikwit sufered has been crowded out by generations who have never experienced the horrors of Ebola have
the continual eruption of deadly diseases elsewhere in the Congo, been born in Kikwit. Protective equipment to shield doctors and
and around the globe. nurses from contaminated blood has vanished, even as the virus
Emery Mikolo, a 55-year-old Congolese man with a wide, has continued to emerge in other corners of the country. The city’s
angular face, walks with me. Mikolo survived his own encounter population has tripled. New neighborhoods have sprung up. In one
with Ebola in 1995. As he looks at the rest- of them, I walk through a market, gazing at
ing place of those who didn’t, his solemn delectable displays of peppers, eggplants,
demeanor cracks a bit. In the Congo, when avocados, and goat meat. Pieces of salted
people die, their bodies are meant to be ish sell for 300 Congolese francs—about
cleaned by their families. They should be the equivalent of an American quarter.
dressed, caressed, kissed, and embraced. Juicy white grubs go for 1,000. And the
These intense rituals of love and com- biggest delicacy of all goes for 13,000—a
munity were corrupted by Ebola, which
THE ORDEAL roasted monkey, its charred face pre-
harnessed them to spread through entire KIKWIT served in a deathly grimace.
families. Eventually, of necessity, they SUFFERED The monkey surprises me. Mikolo
were eliminated entirely. Until Ebola, “no is surprised to see only one. Usually, he
one had ever taken bodies and thrown HAS BEEN says, these stalls are heaving with mon-
them together like sacks of manioc,” CROWDED keys, bats, and other bushmeat, but rains
Mikolo tells me.
The Congo—and the world—first
OUT BY THE the night before must have stranded any
hunters in the eastern forests. As I look
learned about Ebola in 1976, when a CONTINUAL around the market, I picture it as an eco-
mystery illness emerged in the northern ERUPTION logical magnet, drawing in all the varied
village of Yambuku. Jean-Jacques Muy- animals that dwell within the forest—and
embe, then the country’s only virologist,
OF DEADLY all the viruses that dwell within them.
collected blood samples from some of DISEASES The Congo is one of the most bio-
the irst patients and carried them back ELSEWHERE diverse countries in the world. It was
to Kinshasa in delicate test tubes, which here that HIV bubbled into a pandemic,
bounced on his lap as he trundled down
IN THE eventually detected half a world away,
undulating roads. From those samples, CONGO. in California. It was here that monkey-
which were shipped to the Centers pox was irst documented in people. The
for Disease Control and Prevention in country has seen outbreaks of Marburg

60 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
virus, Crimean-Congo hemorrhagic fever, chikungunya virus, afected by the 2014 West African outbreak. About eight inter-
yellow fever. These are all zoonotic diseases, which originate in national lights depart daily from the city’s airport.
animals and spill over into humans. Wherever people push into If Ebola hit Kikwit today, “it would arrive here easily,” Muy-
wildlife-rich habitats, the potential for such spillover is high. embe tells me in his office at the National Institute for Bio-
Sub-Saharan Africa’s population will more than double during medical Research, in Kinshasa. “Patients will leave Kikwit
the next three decades, and urban centers will extend farther to seek better treatment, and Kinshasa will be contaminated
into wilderness, bringing large groups of immunologically naive immediately. And then from here to Belgium? Or the U.S.?” He
people into contact with the pathogens that skulk in animal laughs, morbidly.
reservoirs—Lassa fever from rats, monkeypox from primates “What can you do to stop that?,” I ask.
and rodents, Ebola from God-knows-what in who-knows-where. “Nothing.”

N E H U N D R E D Y E A R S AG O,

O in 1918, a strain of H1N1 flu


swept the world. It might have
originated in Haskell County, Kansas,
or in France or China—but soon it was
everywhere. In two years, it killed as
many as 100 million people—5 percent
of the world’s population, and far more
than the number who died in World War I.
It killed not just the very young, old, and
sick, but also the strong and it, bringing
them down through their own violent
immune responses. It killed so quickly that
hospitals ran out of beds, cities ran out of
coins, and coroners could not meet the
demand for death certiicates. It lowered
Americans’ life expectancy by more than a
decade. “The lu resculpted human popu-
lations more radically than anything since
the Black Death,” Laura Spinney wrote in
Pale Rider, her 2017 book about the pan-
demic. It was one of the deadliest natural
disasters in history—a potent reminder of
Survivors of the Kikwit Ebola epidemic, from left: Emilienne Luzolo,
the threat posed by disease.
Shimene Mukungu, and Emery Mikolo in 1995. Mikolo, the first of the three to be
infected, later donated his antibody-rich blood to Luzolo and Mukungu. Humanity seems to need such remind-
ers often. In 1948, shortly after the irst
flu vaccine was created and penicillin
became the first mass-produced anti-
On average, in one corner of the world or another, a new infec- biotic, U.S. Secretary of State George Marshall reportedly
tious disease has emerged every year for the past 30 years: MERS, claimed that the conquest of infectious disease was imminent.
Nipah, Hendra, and many more. Researchers estimate that In 1962, after the second polio vaccine was formulated, the Nobel
birds and mammals harbor anywhere from 631,000 to 827,000 Prize–winning virologist Sir Frank Macfarlane Burnet asserted,
unknown viruses that could potentially leap into humans. Valiant “To write about infectious diseases is almost to write of some-
eforts are under way to identify them all, and scan for them in thing that has passed into history.”
places like poultry farms and bushmeat markets, where animals Hindsight has not been kind to these proclamations. Despite
and people are most likely to encounter each other. Still, we likely advances in antibiotics and vaccines, and the successful eradi-
won’t ever be able to predict which will spill over next; even long- cation of smallpox, Homo sapiens is still locked in the same epic
known viruses like Zika, which was discovered in 1947, can sud- battle with viruses and other pathogens that we’ve been ighting
denly develop into unforeseen epidemics. since the beginning of our history. When cities irst arose, dis-
The Congo, ironically, has a good history of containing its dis- eases laid them low, a process repeated over and over for millen-
eases, partly because travel is so challenging. Most of the country nia. When Europeans colonized the Americas, smallpox followed.
is covered by thick forest, crisscrossed by just 1,700 miles of road. When soldiers fought in the irst global war, inluenza hitched a
Large distances and poor travel infrastructure limited the spread ride, and found new opportunities in the unprecedented scale of
of Ebola outbreaks in years past. the conlict. Down through the centuries, diseases have always
But that is changing. A 340-mile road, lanked by deep val- excelled at exploiting lux.
leys, connects Kikwit to Kinshasa. In 1995, that road was so badly Humanity is now in the midst of its fastest-ever period of
EMERY MIKOLO

maintained that the journey took more than a week. “You’d have change. There were almost 2 billion people alive in 1918; there
to dig yourself out every couple of minutes,” Mikolo says. Now are now 7.6 billion, and they have migrated rapidly into cities,
the road is beautifully paved for most of its length, and can which since 2008 have been home to more than half of all human
be traversed in just eight hours. Twelve million people live in beings. In these dense throngs, pathogens can more easily spread
Kinshasa—three times the combined population of the capitals and more quickly evolve resistance to drugs. Not coincidentally,

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 61
the total number of outbreaks per decade Bill Gates, whose foundation has
has more than tripled since the 1980s. studied pandemic risks closely, is not a
Globalization compounds the risk: Air- man given to alarmism. But when I spoke
planes now carry almost 10 times as many
THE WHITE with him upon my return from Kikwit,
passengers around the world as they did HOUSE he described simulations showing that a
four decades ago. In the ’80s, HIV showed IS NOW HOME severe lu pandemic, for instance, could
how potent new diseases can be, by kill more than 33 million people world-
launching a slow-moving pandemic that TO AN wide in just 250 days. That possibility,
has since claimed about 35 million lives. INATTENTIVE, and the world’s continued inability to
In 2003, another newly discovered virus,
SARS, spread decidedly more quickly. A
CONSPIRACY- adequately prepare for it, is one of the
few things that shake Gates’s trademark
Chinese seafood seller hospitalized in MINDED optimism and challenge his narrative of
Guangzhou passed it to dozens of doctors PRESIDENT. global progress. “This is a rare case of me
and nurses, one of whom traveled to Hong being the bearer of bad news,” he told me.
Kong for a wedding. In a single night, he
WE SHOULD “Boy, do we not have our act together.”
infected at least 16 others, who then NOT UNDER- Preparing for a pandemic ultimately
carried the virus to Canada, Singapore, ESTIMATE boils down to real people and tangible
and Vietnam. Within six months, SARS things: A busy doctor who raises an eye-
had reached 29 countries and infected
WHAT brow when a patient presents with an
more than 8,000 people. This is a new THAT COULD unfamiliar fever. A nurse who takes a
epoch of disease, when geographic barri- MEAN. travel history. A hospital wing in which
ers disappear and threats that once would patients can be isolated. A warehouse
have been local go global. where protective masks are stockpiled. A
Last year, with the centennial of the 1918 factory that churns out vaccines. A line on
lu looming, I started looking into whether a budget. A vote in Congress. “It’s like a
America is prepared for the next pandemic. chain—one weak link and the whole thing
I fully expected that the answer would be no. What I found, after falls apart,” says Anthony Fauci, the director of the National Insti-
talking with dozens of experts, was more complicated—reassuring tute of Allergy and Infectious Diseases. “You need no weak links.”
in some ways, but even more worrying than I’d imagined in others.
Certainly, medicine has advanced considerably during the past MONG ALL KNOWN PANDEMIC THREAT S, inlu-
century. The United States has nationwide vaccination programs,
advanced hospitals, the latest diagnostic tests. In the National
Institutes of Health, it has the world’s largest biomedical research
A enza is widely regarded as the most dangerous. Its vari-
ous strains are constantly changing, sometimes through
subtle mutations in their genes, and sometimes through dramatic
establishment, and in the CDC, arguably the world’s strongest reshules. Even in nonpandemic years, when new viruses aren’t
public-health agency. America is as ready to face down new sweeping the world, the more familiar strains kill up to 500,000
diseases as any country in the world. people around the globe. Their ever-changing nature explains why
Yet even the U.S. is disturbingly vulnerable—and in some the lu vaccine needs to be updated annually. It’s why a disease
respects is becoming quickly more so. It depends on a just-in- that is sometimes little worse than a bad cold can transform into
time medical economy, in which stockpiles are limited and even a mass-murdering monster. And it’s why lu is the disease the U.S.
key items are made to order. Most of the intravenous bags used has invested the most in tracking. An expansive surveillance net-
in the country are manufactured in Puerto Rico, so when Hurri- work constantly scans for new lu viruses, collating alerts raised by
cane Maria devastated the island last September, the bags fell doctors and results from lab tests, and channeling it all to the CDC,
in short supply. Some hospitals were forced to inject saline with the spider at the center of a thrumming worldwide web.
syringes—and so syringe supplies started running low too. The Yet just 10 years ago, the virus that the world is most prepared
most common lifesaving drugs all depend on long supply chains for caught almost everyone of guard. In the early 2000s, the CDC
that include India and China—chains that would likely break in a was focused mostly on Asia, where H5N1—the type of lu deemed
severe pandemic. “Each year, the system gets leaner and leaner,” most likely to cause the next pandemic—was running wild among
says Michael Osterholm, the director of the Center for Infectious poultry and waterfowl. But while experts fretted about H5N1 in
Disease Research and Policy at the University of Minnesota. “It birds in the East, new strains of H1N1 were evolving within pigs
doesn’t take much of a hiccup anymore to challenge it.” in the West. One of those swine strains jumped into humans in
Perhaps most important, the U.S. is prone to the same forget- Mexico, launching outbreaks there and in the U.S. in early 2009.
fulness and shortsightedness that befall all nations, rich and The surveillance web picked it up only in mid-April of that year,
poor—and the myopia has worsened considerably in recent years. when the CDC tested samples from two California children who
Public-health programs are low on money; hospitals are stretched had recently fallen ill.
perilously thin; crucial funding is being slashed. And while we tend One of the most sophisticated disease-detecting networks in
to think of science when we think of pandemic response, the worse the world had been blindsided by a virus that had sprung up in
the situation, the more the defense depends on political leadership. its backyard, circulated for months, and snuck into the country
When Ebola lared in 2014, the science-minded President unnoticed. “We joked that the inluenza virus is listening in on
Barack Obama calmly and quickly took the reins. The White our conference calls,” says Daniel Jernigan, who directs the CDC’s
House is now home to a president who is neither calm nor Inluenza Division. “It tends to do whatever we’re least expecting.”
science-minded. We should not underestimate what that may The pandemic caused problems for vaccine manufacturers,
mean if risk becomes reality. too. Most lu vaccines are made by growing viruses in chicken

62 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
© 2018 Optum,® Inc. All rights reserved.
HOW WELL
GETS DONE.
Knowing not guessing.
Implementing not theorizing.
This is how fragmented care becomes more connected.
How higher quality is delivered at a lower cost.
How chronic illness becomes not so chronic.
How data is gathered and analysis inspires action.
How collaboration becomes more contagious.
This is how we tackle the biggest challenges
in health care and build
a healthier world.

optum.com

Data and Analytics | Pharmacy Care Services | Population Health Management | Health Care Delivery | Health Care Operations
eggs—the same archaic method that’s been used for 70 years. cookers that use steam to sterilize equipment—so that soiled lin-
Every strain grows differently, so manufacturers must con- ens and clothes can be immediately decontaminated. The space
stantly adjust to each new peculiarity. Creating lu vaccines is is under negative air pressure: When doctors enter the hallway, or
an artisanal afair, more like cultivating a crop than making a any of the ive patient rooms, air lows in with them, preventing
pharmaceutical. The process works reasonably well for seasonal viruses from drifting out. This also dries the air. Working here,
lu, which arrives on a predictable schedule. It fails miserably for I’m told, is murder on the skin.
pandemic strains, which do not. Almost everything in the unit is a barrier of some form. Floor
In 2009, the vaccine for the new pandemic strain of H1N1 lu seams are welded. Light and plumbing ixtures are sealed. The
arrived slowly. (Then–CDC Director Tom Frieden told the press, ventilation and air-conditioning systems are separate from those
“Even if you yell at the eggs, it won’t grow any faster.”) Once the for the rest of the hospital, and rigorously iltered. Patients can be
pandemic was oicially declared, it took four months before the wheeled in on a tented gurney with built-in glove ports; it looks
doses even began to roll out in earnest. By then the disaster was like a translucent caterpillar whose legs have been pushed inward.
already near its peak. Those doses prevented no more than 500 A separate storage room is stocked with full-body suits, tape for
deaths—the fewest of any lu season in the surrounding 10-year sealing the edges of gloves, and space-suit-like hoods with their
period. Some 12,500 Americans died. own air ilter. A videoconferencing system allows team members—
The egg-based system depends on chickens, which are them- and family—to monitor what happens in the patient rooms without
selves vulnerable to lu. And since viruses can mutate within the having to suit up themselves. A roll of heavy-duty metallic wrap-
eggs, the resulting vaccines don’t always match the strains that ping paper can be used to seal the body of anyone who dies.
are circulating. But vaccine makers have few incentives to use The unit is currently empty, as it has been for most of its exis-
anything else. Switching to a diferent process would cost billions, tence. The beds are occupied only by four hyperrealistic manne-
and why bother? Flu vaccines are low-margin products, which quins, upon which nurses can practice medical procedures while
only about 45 percent of Americans get in a normal year. So when wearing cumbersome protective layers. “We’ve named all the
demand soars during a pandemic, the supply is not set to cope. mannequins,” Boulter tells me. Pointing to the largest one: “That
American hospitals, which often operate unnervingly close to one’s Phil, after Dr. Smith.”
full capacity, likewise struggled with the surge of patients. Pedi- Phil Smith began pushing the hospital to build the
atric units were hit especially hard by H1N1, and staf became biocontainment unit in 2003, back when he was a professor
exhausted from continuously caring for sick children. Hospitals of infectious diseases. SARS had emerged from nowhere, and
almost ran out of the life-support units that sustain people whose monkeypox had broken out in the Midwest; Smith realized the
lungs and hearts start to fail. The health-care system didn’t break, U.S. had no facilities that could handle such diseases, beyond
but it came too close for comfort—especially for what turned out a few high-security research labs. With support from the state
to be a training-wheels pandemic. The 2009 H1N1 strain killed health department, he opened the unit in 2005.
merely 0.03 percent of those it infected; by contrast, the 1918 And then, nothing happened.
strain had killed 1 to 3 percent, and the H7N9 strain currently For nine years, the facility was dormant, acting mostly as an
circulating in China has a fatality rate of 40 percent. overlow ward. “We didn’t know if it would be needed, but we
“A lot of people said that we dodged a bullet in 2009, but nature planned and prepared as if it would,” says Shelly Schwedhelm, the
just shot us with a BB gun,” says Richard Hatchett, the CEO of head of the hospital’s emergency-preparedness program, who for
the Coalition for Epidemic Preparedness Innovations. Tom years kept the unit aloat on a shoestring budget. Her eforts paid
Inglesby, a biosecurity expert at the Johns Hopkins Bloomberg of in September 2014, when the State Department called, telling
School of Public Health, told me that if a 1918-style pandemic Schwedhelm and her team to prepare for possible Ebola patients.
hit, his hospital “would need in the realm of seven times as many Over 10 weeks, the unit’s 40 staf members took care of three
critical-care beds and four times as many ventilators as we have infected Americans who had been evacuated from West Africa.
on hand.” They worked around the clock in teams of six, some stafers treat-
That the U.S. could be so ill-prepared for lu, of all things, ing the patients directly, others helping their colleagues put on
should be deeply concerning. The country has a dedicated and take of their gear, and still others supervising from the nurses’
surveillance web, antiviral drugs, and an infrastructure for mak- station. Two of the patients—Rick Sacra, a physician, and Ashoka
ing and deploying lu vaccines. None of that exists for the major- Mukpo, a journalist—were cured and discharged. The third—a
ity of other emerging infectious diseases. surgeon named Martin Salia—was already sufering from organ
failure by the time he arrived, and died two days later. A green-
S I WALK DOWN a seventh-loor hallway of the Uni- marble plaque now hangs in the unit to honor him.

A versity of Nebraska Medical Center, Kate Boulter, a


nurse manager, points out that the carpet beneath my
feet has disappeared, exposing bare loors that are more easily
The University of Nebraska Medical Center is one of the best
in the country at handling dangerous and unusual diseases, Ron
Klain, who was in charge of the Obama administration’s Ebola
cleaned. In an otherwise unmarked corridor, this, she says, is the response, tells me. Only the NIH and Emory University Hos-
irst sign that I am approaching the biocontainment unit—a spe- pital have biocontainment units of a similar standard, he says,
cial facility designed to treat the victims of bioterror attacks, or but both are smaller. Those three hospitals were the only ones
patients with a deadly infectious disease such as Ebola or SARS. ready to take patients when Ebola struck in 2014, but within two
There is nothing obviously special about the 4,100 square months, Klain’s team had raised the number to 50 facilities. It
feet, but every detail has been carefully designed to give patients was “a lot of hard work,” he says. “But ultimately, we had 144
maximal access to the best care, and viruses minimal access to beds.” A more contagious and widespread disease would have
anything. A supply room is stocked with scrubs, underwear, and overwhelmed them all.
socks, so that no piece of clothing staf members wear at work Preparing hospitals for new epidemics is challenging in the
will make its way home. There are two large autoclaves—pressure United States, Klain says, because health care is so decentralized:

64 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
“You and I could decide that every hospital should have three beds them with immunosuppressants? If ICUs are full, where could
capable of isolating people with a dangerous disease, and Trump they create clean spaces for post-transplant recovery? It matters
could agree with us, and there’s no way of making that happen.” that the hospital has considered these questions. It matters just
Hospitals are independent entities; in this fractured environ- as much that the people in charge have met, talked, and estab-
ment, preparedness is less the result of governmental mandate lished a bond.
and more the product of individual will. It comes from dedicated The members of the team running the biocontainment
visionaries like Smith and skilled managers like Schwedhelm, unit all work in diferent parts of the hospital, as pediatricians,
who can keep things going when there’s no immediate need. critical-care specialists, obstetricians. But even during the unit’s
The trio of Ebola patients in 2014 produced 3,700 pounds of long dormancy, Schwedhelm would gather them for quarterly
contaminated linens, gloves, and other waste among them, all training sessions. That’s why, when the moment came, they were
of which demanded careful handling. Treating them cost more ready. When they escorted the Ebola patients of their respective
than $1 million. That kind of care quickly reaches its limits as an planes, the staf members recalled what they had learned during
epidemic spreads. In June 2015, the Samsung Medical Center, in practice drills.
Seoul—one of the most advanced medical centers in the world— “We do a lot of team building,” Boulter says, showing me a
was forced to suspend most of its services after a single man with photo of the group at a ropes course.
MERS arrived in its overcrowded emergency room. American “It was the scariest thing I’ve ever done,” Schwedhelm says.
hospitals wouldn’t fare much better. But at the very least, they They followed that up with something more sedate—a movie
can plan for the worst. night in the hospital auditorium. They watched Contagion.
Schwedhelm, with a 100-person team, has been creating plans
for how every aspect of hospital operation would need to work IKWIT GENERAL HOSPITAL has no biocontainment
during a pandemic. How much should hospitals stockpile? How
would they provide psychological support during a weeks-long cri-
sis? How could they feed people working longer-than-usual shifts?
K unit. Instead, it has Pavilion 3.
Emery Mikolo, who works at the hospital as a nurse
supervisor, takes me into the blue-walled, open-windowed
When would they cancel elective surgeries? Where could they get building that is now the pediatrics ward. In one room, mos-
extra disinfectant, mop heads, and other cleaning supplies? quito nets are suspended hammocklike over 16 closely packed
At a single meeting, I hear two dozen people discuss how beds, on which mothers care for young children and newborn
they would care for the 400 or so patients on the hospital’s babies. This is a place of new life. But in 1995, it was the infamous
organ-transplant list. How would they get such patients into the “death ward,” where Ebola patients were treated. Exhausted doc-
facility safely? At what point would it become too risky to pump tors struggled to control the outbreak; outside the hospital, the

Counterclockwise from bottom right: Phil Smith, who opened


Nebraska’s biocontainment unit in 2005; Shelly Schwedhelm,
who directs the hospital’s emergency-preparedness program;
a containment vessel for infected patients
military established a perimeter to turn back leeing patients. allowed the virus to spread among the staf of Kikwit’s hospital,
The dead were laid in a row on the pavement. just as it did among nurses in Dallas, where an infected patient
We walk into another room, which is largely empty except landed in September 2014. In Kikwit, a lack of running water
for a poster of a cartoonish girafe, a few worn mattresses, and makes hygiene a luxury, but even in the U.S., getting medical
some old bed frames. Mikolo touches one of them. It was his, he professionals to wash their hands or follow other best practices is
says. He looks around quietly and shakes his head. Many of the surprisingly hard; every year, at least 70,000 Americans die after
people who shared this room with him were his colleagues who picking up infections in hospitals. And most of all, the people in
had become infected while they cared for patients. Ebola’s symp- both countries worry that brief spates of foresight and prepared-
toms are sometimes mythologized: Organs don’t liquefy; blood ness will always give way to negligence and entropy.
seldom pours from oriices. But the reality is no less gruesome. In the U.S., attention and money have crested and then crashed
“It was like a horror movie,” he says. “All these people I worked with each new crisis: anthrax in 2001, SARS in 2003. Resources,
with—my friends—throwing up, screaming, dying, falling out of hurriedly assembled, dwindle. Research into countermeasures
bed.” At one point, delirious with fever, he too rolled of his mat- izzles. “We fund this thing like Minnesota snow,” Michael Oster-
tress. “There was vomit and piss and shit on the ground, but at holm says. “There’s a lot in January, but in July it’s all melted.”
least it was cool.” Take the Hospital Preparedness Program. It’s a funding
Many of the people who worked at the hospital during the plan that was created in the wake of 9/11 to help hospitals ready
outbreak are still there. Jacqui, a nurse, worked in Pavilion 3 and themselves for disasters, run training drills, and build their surge
returned there only three years ago. She was terriied at irst, capacity— everything that Shelly Schwedhelm’s team does so well
but she soon habituated. I ask whether she’s worried that Ebola in Nebraska. It transformed emergency planning from an after-
might return. “I’m not afraid,” she says. “It’s never coming back.” hours avocation into an actual profession, carried out by skilled
If it does, is there any protective equipment at the hospital? specialists. But since 2003, its $514 million budget has been halved.
“No,” she tells me. Another fund—the Public Health Emergency Preparedness
Mikolo laughs. “Article 15,” he says. program—was created at the same time to help state and local
Article 15 is something of a Congolese catchphrase, referring health departments keep an eye on infectious diseases, improve
to a ictional but universally recognized 15th article of the coun- their labs, and train epidemiologists. Its budget has been
try’s constitution, “Débrouillez-vous”—“igure it out yourself.” I pruned to 70 percent of its $940 million peak. Small wonder,
hear it everywhere. It is simultaneously a
testament to the Congolese love for droll
humor, a weary acknowledgment of hard-
Ron Klain was appointed the “Ebola czar” by President Obama in 2014
ship, a screw-you to the establishment,
to provide speed and order to a federal response that required
and a motivational mantra. No one’s going many agencies and was marked by unclear lines of responsibility.
to ix your problems. You must make do with
what you’ve got.
In a nearby room, dried blood dots
the loor around an old operating table,
where a sick lab technician once passed
Ebola to five other medical staff mem-
bers, starting a chain of transmission that
eventually enveloped Mikolo and many
of his friends. The phlebotomist who
drew the blood samples that were used to
conirm Ebola also still works at the hos-
pital. I watch as he handles a rack of sam-
ples with his bare hands. “Ask someone
here, ‘Where are the kits that protect you
from Ebola?,’ ” Donat Kuma-Kuma Kenge,
the hospital’s chief coordinator, tells me.
“There aren’t any. I know exactly what I’m
meant to do, but there are no materials—
here, in the place where there was Ebola.
“Débrouillez-vous,” he adds.
The hospital’s challenges are con-
siderable, but as I walk around, I realize
that they are familiar. Even though the
United States is 500 times as wealthy
as the Congo, the laments I heard from
people in both countries were uncannily
similar— different in degree, but not in
kind. Protective equipment is scarce in
the Congo, but even America’s stock-
piles would quickly be depleted in a seri-
ous epidemic. Unfamiliarity with Ebola

66 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
then, that in the past decade, local health most likely to cause a pandemic. Those
departments have cut more than 55,000 doses are stockpiled, and can be used to
jobs. That’s 55,000 people who won’t be immunize health-care workers, govern-
there to answer the call when the next
THOUGH ment employees, and the military while
epidemic hits. THE U.S. the Holly Springs plant churns out more.
These sums of money are paltry com- IS VASTLY Yet even this strategy is imperfect.
pared with what another pandemic might When H7N9 irst appeared in China, in
cost the country. Diseases are exorbi-
WEALTHIER 2013, the plant did its job, creating a vac-
tantly expensive. In response to just 10 THAN THE cine that was then stockpiled. Since then,
cases of Ebola in 2014, the U.S. spent
$1.1 billion on domestic preparations,
CONGO, THE H7N9 has mutated, and the hoarded
doses may be inefective against the cur-
including $119 million on screening and LAMENTS rent strains. “We occasionally have to
quarantine. A severe 1918-style flu pan- I HEARD chase a pre-pandemic,” says Anthony
demic would drain an estimated $683 bil-
lion from American cofers, according to
IN BOTH Fauci, the National Institute of Allergy
and Infectious Diseases (NIAID) direc-
the nonproit Trust for America’s Health. COUNTRIES tor. “We have to do it,” but the strategy
The World Bank estimates that global ABOUT HOW remains wasteful and reactive.
output would fall by almost 5 percent— What society really needs, Fauci tells
totaling some $4 trillion.
THINGS me, is a universal lu vaccine— one that
The U.S. is not unfamiliar with the COULD GO protects against every variant of the
concept of preparedness. It currently WRONG virus and provides long-term protection,
spends roughly half a trillion dollars on just as the vaccines against measles and
its military—the highest defense budget
WERE mumps do. One vaccine to bind them
in the world, equal to the combined bud- UNCANNILY all: It’s hard to overstate what a win that
gets of the next seven top countries. But SIMILAR. would be. No more worrying about strain
against viruses—more likely to kill mil- mismatches or annual injections. “It
lions than any rogue state is—such consis- would be the epitome of preparedness,”
tent investments are nowhere to be found. Fauci says, and he has committed his
institute to developing one.
T A M O D E R N BU I L D I N G in Flu viruses are studded with a mole-

A Holly Springs, on the outskirts of Raleigh, North Caro-


lina, I walk down a wide corridor where the words IT
REALLY IS A MATTER OF LIFE AND DEATH have been stenciled
cule called hemagglutinin (the H in H1N1 and other such names),
which looks like a stumpy Pez dispenser. Vaccines target the head,
but that’s the part that varies most among strains, and evolves most
on a yellow wall. The walkway leads to a refrigerator-cool ware- quickly. Targeting the stem, which is more uniform and stable,
house, where several white containers sit on a blue pallet. The might yield better results. The stem, however, is usually ignored by
containers are full of flu vaccine, and each holds enough to the immune system. To draw attention to it, Fauci’s team decapi-
immunize more than 1 million Americans. When their contents tates the molecule and sticks the stem onto a nanoparticle. The
are ready to be used, they head toward a long, Rube Goldberg– result looks like a lu virus, but encourages the immune system to
esque machine that dispenses the vaccine into syringes—more go after the stable stem instead of the adaptable head. In a prelimi-
than 400,000 a day. nary study, his team used this approach to build a vaccine using
Instead of eggs, the facility grows lu viruses in lab-grown dog an H1 virus, which then protected ferrets against a very diferent
cells, which ill 5,000-liter steel vats one loor above. The cells H5N1 strain.
are infected with lu viruses, which quickly propagate. The tech- This type of work is promising, but flu is such an adaptive
nique is faster than using eggs, and produces vaccines that are a adversary that the quest for a universal vaccine might take years,
closer match to circulating strains. even decades, to fulill. Progress will be incremental, but each
This facility is the result of a partnership between the pharma- increment will have value in itself. A universal-ish vaccine that, say,
ceutical company Seqirus and a government agency called the protected against all H1N1 strains would have prevented the 2009
Biomedical Advanced Research and Development Authority. pandemic. And reducing lu’s menace, even in some of its variants,
Established in 2006, BARDA acts more or less as a venture-capital would free up resources and intellectual capacity for dealing with
irm, funding the development of vaccines, drugs, and other epi- other deadly diseases for which no vaccines exist at all.
demic countermeasures that would otherwise be unproitable. In Many of those diseases strike poor countries irst and are—for
2007, it entered into a $1 billion partnership to create the Holly now—rare. Creating vaccines for them is painstaking and often
Springs plant, which started making vaccines in 2011. “No one unprofitable, and therefore little gets done. Last year, to help
would have taken the risk of disposing of egg manufacturing change that, the Coalition for Epidemic Preparedness Innovations
unless they could reach the scale we have here,” says Marie Mazur, was created, and now has $630 million pledged by governments
Seqirus’s vice president of pandemic response. and nonproits. It will focus irst on Lassa fever, Nipah, and MERS,
The facility will soon be able to make 200 million doses of vac- and its ambition is to yank promising vaccines out of developmen-
cine within the irst six months of a new pandemic—enough to tal purgatory, push them through trials, and stockpile them by the
immunize more than one in every three Americans. Six months hundreds of thousands. (One goal is to avoid a repeat of 2014,
is still a long time, though, and there are limits to how quick the when Ebola ravaged West Africa while an experimental vaccine
process can be. To vaccinate people during that window, Seqirus that could potentially have stopped it was languishing in a freezer,
also prepares vaccines against the lu strains that BARDA deems where it had been for a decade.)

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 67
More important, the coalition is look-
ing to fund so-called platform technolo-
gies that could create a vaccine against
any new virus far more quickly than can
be done today: within 16 weeks of its
discovery. Most current vaccines work by
presenting the immune system with dead,
weakened, or fragmented microbes. Every
microbe is unique, so every vaccine must
be unique, which is one reason they’re so
time-consuming to create. But by loading
key parts of a given microbe onto a stan-
dard molecular chassis, scientists could
build plug-and-play vaccines that could
be swiftly customized.
In the same way that movable type
revolutionized printing by allowing peo-
ple to rapidly set up new pages without
carving bespoke woodblocks, such vac-
cines could greatly accelerate the defense
against emerging infections. In 2016, a
team of researchers used the concept to
create a vaccine against Zika that is now
being tested in clinical trials across the
Americas. The process took four months—
the shortest development time in vaccin-
ology’s 222-year history.
The possibilities of vaccine science—
a universal flu vaccine, plug-and-play
platforms—are exciting. But they are only
possibilities. No matter how brilliant and
dedicated the people involved, they face
a long and uncertain road. Missteps and
failures are assured along the way; dogged
efort and consistent support are essential
to sustain the journey. These latter neces-
Anthony Fauci, who as head of the National Institute of Allergy and Infectious Diseases has,
sities, unavoidably, bring us to politics— until now, helped every president starting with Ronald Reagan manage pandemic risk,
where they are, predictably, in short supply. says the responses of the presidents varied widely. He has yet to meet with Donald Trump.

NTHONY FAUCI’S oice walls

A are plastered with certificates,


magazine articles, and other mementos from his 34-year
career as NIAID director, including photos of him with various pres-
There surely will be, though. At some point, a new virus will
emerge to test Trump’s mettle. What happens then? He has no
idents. In one picture, he stands in the Oval Oice with Bill Clinton background in science or health, and has surrounded himself
and Al Gore, pointing to a photo of HIV latching onto a white blood with little such expertise. The President’s Council of Advisers
cell. In another, George W. Bush fastens the Presidential Medal on Science and Technology, a group of leading scientists who
of Freedom around his neck. Fauci has counseled every president consult on policy matters, is dormant. The Oice of Science and
from Ronald Reagan through Barack Obama about the problem of Technology Policy, which has advised presidents on everything
epidemics, because each of them has needed that counsel. “This from epidemics to nuclear disasters since 1976, is diminished.
transcends administrations,” he tells me. The head of that oice typically acts as the president’s chief sci-
Reagan and the elder Bush had to face the emergence and entiic consigliere, but to date no one has been appointed.
proliferation of HIV. Clinton had to deal with the arrival of West Other parts of Trump’s administration that will prove crucial
Nile virus. Bush the younger had to contend with anthrax and during an epidemic have operated like an Etch A Sketch. Dur-
SARS. Barack Obama saw a lu pandemic in his third month in ing the nine months I spent working on this story, Tom Price
oice, MERS and Ebola at the start of his second term, and Zika resigned as secretary of health and human services after using
at the dusk of his presidency. The responses of the presidents taxpayer money to fund charter flights (although his replace-
varied, Fauci told me: Clinton went on autopilot; the younger ment, Alex Azar, is arguably better prepared, having dealt with
Bush made public health part of his legacy, funding an aston- anthrax, lu, and SARS during the Bush years). Brenda Fitzgerald
ishingly successful anti-HIV program; Obama had the keenest stepped down as CDC director after it became known that she
intellectual interest in the subject. had bought stock in tobacco companies; her replacement, Robert
And Donald Trump? “I haven’t had any interaction with him Redield, has a long track record studying HIV, but relatively little
yet,” Fauci says. “But in fairness, there hasn’t been a situation.” public-health experience.

68 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Rear Admiral Tim Ziemer, a veteran malaria fighter, was Counterintuitively, light bans increase the odds that outbreaks
appointed to the National Security Council, in part to oversee will spread by driving fearful patients underground, forcing
the development of the White House’s forthcoming biosecurity them to seek alternative and even illegal transport routes. They
strategy. When I met Ziemer at the White House in February, he also discourage health workers from helping to contain foreign
hadn’t spoken with the president, but said pandemic prepared- outbreaks, for fear that they’ll be denied reentry into their home
ness was a priority for the administration. He left in May. country. Trump clearly felt that such Americans should be denied
Organizing a federal response to an reentry. “KEEP THEM OUT OF HERE!”
emerging pandemic is harder than one he tweeted, before questioning the evi-
might think. The largely successful U.S. dence that Ebola is not as contagious as
response to Ebola in 2014 beneited from is commonly believed.
the special appointment of an “Ebola Trump called Obama “dumb” for
czar”—Klain—to help coordinate the many deploying the military to countries sufer-
agencies that face unclear responsibilities. ing from the Ebola outbreak, and he now
In 2016, when Obama asked for $1.9 bil-
lion to ight Zika, Congress devolved into
SEVERE commands that same military. His dislike
of outsiders and disdain for diplomacy
partisan squabbling. Republicans wanted OUTBREAKS could lead him to spurn the cooperative,
to keep the funds away from clinics that TEAR outward-facing strategies that work best
worked with Planned Parenthood, and to contain emergent pandemics.
Democrats opposed the restriction. It
COMMUNITIES Perhaps the two most important
took more than seven months to appropri- APART, things a leader can personally provide
ate $1.1 billion; by then, the CDC and NIH FORCING in the midst of an epidemic are reliable
had been forced to divert funds meant to information and a unifying spirit. In
deal with lu, HIV, and the next Ebola.
PEOPLE the absence of strong countermeasures,
How will Trump manage such a situ- TO FEAR severe outbreaks tear communities apart,
ation? Back in 2014, he called Obama
a “psycho” for not banning lights from
THEIR forcing people to fear their neighbors; the
longest-lasting damage can be psycho-
Ebola-afflicted countries, even though NEIGHBORS. social. Trump’s tendency to tweet rashly,
no direct lights existed, and even though delegitimize legitimate sources of infor-
health experts noted that travel restric- mation, and readily buy into conspiracy
tions hadn’t helped control SARS or H1N1. theories could be disastrous.

70 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Left to right:
A plaque
memorializing
Dr. Martin Salia,
who died from
Ebola at the
University of
Nebraska Medical
Center in 2014;
a worker sealing
her gloves;
mother and
baby mannequins
used for practicing
treatment

M E R Y M I KO L O G R E E T S M E WA R M LY, with one Congo, Rimoin has shown that monkeypox is on the rise, helped

E outstretched hand. We shake, do a little ankle tap, and


say, “Nous sommes ensemble”—“we are together.” This is
the greeting of the Kikwit Ebola Survivors’ Association, of which
discover a new virus, and worked to create the irst truly accu-
rate maps of the country, down to the most-isolated villages. The
Congo is a second home for her. When Rimoin’s father died
Mikolo is a co-founder and the vice president. Fifteen of the 42 shortly before her wedding, Muyembe, the virologist who irst
members ile into the breakfast room of Hotel Kwilu, the men in encountered Ebola, lew to Los Angeles to walk her down the aisle.
simple shirts and the women in glorious kaleidoscopic dresses. Rimoin emphasized to me the social rupture that disease out-
The youngest are in their mid-30s, the oldest in their late 70s. breaks wreak on unprepared communities, and the diiculty of
They speak softly as they reconnect over plates of bread, cheese, repair. She also said that until the Congo and other developing
and Nutella. countries can control the diseases at their doorsteps, it is impera-
There is still no deinitive treatment for Ebola. In 1995, like tive for richer nations like the United States to help them. That was
most of the survivors, Mikolo fought the virus of on his own, over a truth acknowledged by every expert I spoke with: The best way to
three grueling weeks. After he recovered, he donated his blood— prevent pandemics is to contain outbreaks at their source. The U.S.
and the virus-ighting antibodies within it—to others, saving the cannot possibly consider itself protected if other nations are not.
lives of Shimene Mukungu and Emilienne Luzolo, who are also America’s prior investments in global health preparedness—
here today. Blood spreads Ebola. Sometimes, blood cures it. the largest of any nation’s—have already made a tangible difer-
The outbreak destroyed entire families. Afterward, some of ence. In 2010, the CDC helped Uganda set up a new surveillance
the survivors found themselves the sole providers for several system for viral hemorrhagic fevers like Ebola and Marburg.
children. Others were orphans. Worst of all, they became pariahs. Health workers there are now trained to recognize these diseases,
“Here, for we who live in communities, it is solitude that kills us,” and have tools for collecting samples safely. Labs have diagnostic
Mikolo says. He rolls up his trouser leg and shows me the scars equipment. Response teams are ready to go. “It’s been incred-
inlicted by fearful neighbors, who hurled stones at him when he ible to watch,” says Inger Damon, who oversaw the CDC’s 2014
tried to return home. Like others, he discovered that his house Ebola response. “It used to take two weeks to respond to an out-
and belongings had been burned. break. By the time you understood what was going on, you’d have
The survivors banded together. “We had to take care of our- 20 to 30 cases, and eventually hundreds. Now they can respond
selves,” Norbert Mabanza, the association’s president, tells me. in two days.” Sixteen outbreaks have been detected since 2010,
“Those with a little bit of strength could support those who were but they were typically much smaller and shorter than before.
weaker. Débrouillez-vous.” Half of them involved just one case.
I listen to their stories in the company of Anne Rimoin, an And in July 2014, in the midst of the West African Ebola
epidemiologist from UCLA. During her 16 years working in the outbreak, those investments very likely prevented a horrific

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 71
Emery Mikolo
in March 2018
in Pavilion 3,
which housed
Kikwit’s Ebola
patients in 1995,
and is now a
pediatrics ward

catastrophe that might otherwise still be unfolding today. A Libe- relationships they have built will crumble. Trust is essential for
rian American man brought the virus into Lagos, Nigeria, home controlling outbreaks; it is hard won, and not easily replaced. “In
to 21 million people and one of Africa’s busiest airports. “If it had an outbreak, there’s so little time to learn things, make connec-
gone out of control in Lagos, it would have gone all over Africa for tions, learn how to not ofend people,” Rimoin tells me. “We’re
years,” Tom Frieden, the former CDC director, says. “We were here in the Congo all the time. People know us.”
right on the edge of the abyss.” Until Rimoin arrived in Kikwit last summer, the Ebola survi-
But Nigeria responded quickly. For years, it had used invest- vors had for decades refused to collaborate with outsiders. “Oth-
ments from the U.S. and other countries to build infrastructure ers see us as people to study,” Mikolo tells her. “But you came
for eradicating polio. It had a command center and a crack team to us with friendship and humanity. You haven’t abandoned us.”
of CDC-trained epidemiologists. When Ebola hit Lagos, the Indeed, while Rimoin is studying the blood of the survivors, she
team dropped its polio work. It found every person who’d con- is also trying to set up a clinic where survivors, half of whom are
tracted Ebola, and every person with whom those infected had medically trained, can provide primary care to one another and
had contact. In only three months, after just 19 cases and eight to their communities. She has used donations and some of her
deaths, it brought Ebola to heel and stopped it from spreading to own money to help Mabanza, the association’s president, get a
any other country. master’s degree in public health.
With patience and money—not even very much money com- Rimoin and I take the same light out of Kinshasa; she will
pared with the vastness of rich-country spending—this kind of likely be back in a few months. I think about her ties to the
victory could be commonplace. An international partnership Congo as our plane soars over one of the most biodiverse rain
called the Global Health Security Agenda has already laid out forests in the world, on the irst of three legs that will put me back
a road map for nations to plug their vulnerabilities against within a stone’s throw of the White House in 28 hours. Below
infectious threats. Back in 2014, the U.S. committed $1 billion my light path, the sparks of a new Ebola outbreak are lickering,
to the efort over ive years. With it came a clear, if implicit, unbeknownst to me or any of the scientists with whom I’d spo-
statement: Pandemic threats should be a global priority. Nous ken. (It would be discovered in the weeks that followed.)
sommes ensemble. I think about the survivors of Kikwit, and how our connected-
Given that sense of commitment, and with the related fund- ness is both the source of our greatest vulnerability and the
ing in hand, the CDC made a large bet: It began helping 49 coun- potential means of our salvation. I think about whether it is pos-
tries improve their epidemic preparedness, on the assumption sible to break the old cycle of panic and neglect, to fully transition
that demonstrating success would assure a continued low of from Débrouillez-vous to Nous sommes ensemble. I think about this
money. But that bet now looks uncertain. Trump’s budget for amid bouts of restless sleep, as the plane lies westward across
2019 would cut 67 percent from current annual spending. the Atlantic, stuck in the shadow of the world, until inally, dawn
ED YONG

If investments start receding, the CDC will have to wind catches up.
down its activity in several countries, and its ield oicers will
look for other jobs. Their local knowledge will disappear, and the Ed Yong is a staf writer at The Atlantic.

72 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Cheryl Windless thought it was a simple flu infection. But, assist device (LVAD), which functions like an artificial heart.
she was in severe cardiogenic shock and many of her organs In fact, it was a typical Mount Sinai success story: one that began
were failing. She was given only a ten percent chance of survival. with very little hope of success.
One hospital wouldn’t admit her because they thought she
couldn’t be saved. At Mount Sinai Heart, doctors performed 1 - 8 0 0 - MD-SINA I
emergency surgery to implant a HeartMate II left ventricular mou n t s i n a i .or g/m s he a r t

OUR
DOCTORS WORK ON HEARTS

OTHER DOCTORS

DON’T HAVE THE HEART

TO TOUCH.
Kiarra Boulware
and her niece
at Penn North,
an addiction-
recovery center
in Baltimore
BEING BLACK | TH E H E ALTH REP O RT |

IN AMERICA
CAN BE
HAZARDOUS
Across the United
States, African
Americans have a
lower life expectancy
than whites. In
Baltimore and other
segregated cities,
this gap is as much
as 20 years. One
young woman’s
struggle to get better

TO YOUR
shows why.

BY OLGA KHAZAN
Photographs by Jared Soares

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 75
Kiarra resolved
to get healthy
after visiting
a diabetic friend
in the hospital
who’d had her
toe amputated.
Kiarra’s own
diabetes is
already causing
her vision to blur.

O N E M O R N I N G T H I S PA S T
SEPTEMBER, KIARRA
B O U LWA R E B O A R D E D
T H E 2 6 B U S T O B A LT I M O R E ’ S
B O N S E C O U R S H O S P I TA L ,
where she would seek help for the most urgent prob- not even the best hospitals in America can keep you
lem in her life: the 200-some excess pounds she from getting sick in the irst place.
carried on her 5-foot-2-inch frame. It was lunchtime, but Kiarra didn’t have any cash—
To Kiarra, the weight sometimes felt like a great her job, working the front desk at the recovery center
burden, and at other times like just another fact of where she lived, paid a stipend of just $150 a week.
life. She had survived a childhood marred by death, When she did have money, she often sought comfort
drugs, and violence. She had recently gained control in fast food. But when her cash and food stamps ran
over her addiction to alcohol, which, last summer, out, she sometimes had what she called “hungry
had brought her to a residential recovery center in nights,” when she went to bed without having eaten
the city’s Sandtown neighborhood, made famous by anything all day.
the Freddie Gray protests in 2015. But she still strug- When I’d irst met Kiarra, a few months earlier, I’d
gled with binge eating—so much so that she would been struck by how upbeat she seemed. Her recov-
eat entire plates of quesadillas or mozzarella sticks ery center—called Maryland Community Health
in minutes. Initiatives, but known in the neighborhood as Penn
As the bus rattled past rowhouses and corner North—sits on a grimy street crowded with men sell-
stores, Kiarra told me she hadn’t yet received the ing drugs. Some of the center’s clients, fresh of their
CPAP breathing machine she needed for her sleep habits, seemed withdrawn, or even morose. Kiarra,
apnea. The extra fat seemed to constrict her airways though, had the bubbly demeanor of a student-
while she slept, and a sleep study had shown that she council president.
stopped breathing 40 times an hour. She remem- She described the rough neighborhoods where
bered one doctor saying, “I’m scared you’re going to she’d grown up as fun and “familylike.” She said
die in your sleep.” In the haze of alcoholism, she’d that although neither of her parents had been very
never followed up on the test. Now doctors at Bon involved when she was a kid, her grandparents had
Secours were trying to order the machine for her, but provided a loving home. Regarding her diabetes, she
insurance hurdles had gotten in the way. told me she was “grateful that it’s reversible.” After
Kiarra’s weight brought an assortment of old- finishing her addiction treatment, she planned to
person problems to her 27-year-old life: sleep apnea, reenroll in college and move into a dorm.
diabetes, and menstrual dysregulation, which made Now, though, a much more anxious Kiarra sat
her worry she would never have children. For a while, before her doctor, a young white man named Tyler
she’d ignored these issues. Day to day, her size mostly Gray, who began by advising Kiarra to get a Pap smear.
made it hard to shop for clothes. But the severity of her “Do we have to do it today?” she asked.
situation sank in when a diabetic friend had to have a “Is there something you’re concerned about or ner-
toe amputated. Kiarra visited the woman in the hospi- vous about?,” Gray asked.
tal. She saw her tears and her red, bandaged foot, and Kiarra was nervous about a lot of things. She
resolved not to become an amputee herself. “deals by not dealing,” as she puts it, but lately she’d
Kiarra arrived at the hospital early and waited in had to deal with so much. “Ever since the diabetes
the cafeteria. Bon Secours is one of several world-class thing, I hate hearing I have something else,” she said
hospitals in Baltimore. Another, Johns Hopkins Hospi- softly, beginning to cry. “I’ve been fat for what seems
tal, is in some respects the birthplace of modern Amer- like so long, and now I get all the fat problems.”
ican medicine, having invented everything from the “I don’t want to be fat,” she added, “but I don’t
medical residency to the surgical glove. But of course know how to not be fat.”

76 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Kiarra’s struggles with her weight are imbued with this sense, that getting was a little girl, Baltimore
  W H E N  K I A R R A  
thin is a mystery she might never solve, that diet secrets are literally secret. was, as it is today, mired in
On a Sunday, she might diligently make a meal plan for the week, only to ind violence, drugs, and poverty. In 1996, the city had
herself reaching for Popeyes fried chicken by Wednesday. She blames herself the highest rate of drug-related emergency-room
for her poor health—as do many of the people I met in her community, where visits in the nation and one of the country’s highest
obesity, diabetes, and heart disease are ubiquitous. They said they’d made homicide rates.
bad choices. They used food, and sometimes drugs, to soothe their pain. But With her father in and out of jail for robbery and
these individual failings are only part of the picture. drug dealing, Kiarra and her mother, three siblings,
In Baltimore, a 20-year gap in life expectancy exists between the city’s and three cousins piled into her grandmother’s
poor, largely African American neighborhoods and its wealthier, whiter areas. home. It was a joyous but chaotic household. Kiarra
A baby born in Cheswolde, in Baltimore’s far-northwest corner, can expect describes her grandmother as “God’s assistant”—a
to live until age 87. Nine miles away in Clifton-Berea, near where The Wire deeply religious woman who, despite a house burst-
was ilmed, the life expectancy is 67, roughly the same as that of Rwanda, and ing with hungry mouths, would still make an extra
12 years shorter than the American average. Similar disparities exist in other dinner for the addicts on the block. Kiarra’s mother,
segregated cities, such as Philadelphia and Chicago. meanwhile, was “the hood princess,” a woman who
These cities are among the most extreme examples of a national phe- would do her hair just to go to the grocery store. She
nomenon: Across the United States, black people sufer disproportionately was a teen mom, like her own mother had been.
from some of the most devastating health problems, from cancer deaths and Many facets of Kiarra’s youth—the fact that her
diabetes to maternal mortality and preterm births. Although the racial dis- parents weren’t together, her father’s incarceration,
parity in early death has narrowed in recent decades, black people have the the guns on the corners—are what researchers con-
life expectancy, nationwide, that white people had in the 1980s—about three sider “adverse childhood experiences,” stressful
years shorter than the current white life expectancy. African Americans face events early in life that can cause health problems
a greater risk of death at practically every stage of life. in adulthood. An abnormally large proportion of the
Except in the case of a few specific ailments, such as nondiabetic children in Baltimore—nearly a third—have two or
kidney disease, scientists have largely failed to identify genetic diferences more ACEs. People with four or more ACEs are seven
that might explain racial health disparities. The major underlying causes, times as likely to be alcoholics as people with no ACEs,
many scientists now believe, are social and environmental forces that afect and twice as likely to have heart disease. One study
African Americans more than most other groups. found that six or more ACEs can cut life expectancy
To better understand how these forces work, I spent nearly a year report- by as much as 20 years. Kiarra had at least six.
ing in Sandtown and other parts of Baltimore. What I found in Kiarra’s She and others I interviewed recall the inner-
struggle was the story of how one person’s eforts to get better—imperfect as city Baltimore of their youth fondly. Everyone lived
they may have been—were made vastly more diicult by a daunting series of crammed together with siblings and cousins, but
obstacles. But it is also a bigger story, of how African Americans became stuck people looked out for one another; neighbors hosted
in profoundly unhealthy neighborhoods, and of how the legacy of racism can back-to-school cookouts every year, and people took
literally take years of their lives. Far from being a relic of the past, America’s pride in their homes. Kiarra ran around with the
racist and segregationist history continues to harm black people in the most other kids on the block until her grandma called her
intimate of ways—seeping into their lungs, their blood, even their DNA. in each night at 8 o’clock. She made the honor roll in
ifth grade and got to speak in front of the whole class.
She read novels by Sister Souljah and wrote short sto-
ries in longhand.
Yet Kiarra also describes some jarring incidents.
When she was 8, she heard a loud bop bop bop outside
and ran out to ind her stepbrother lying in the street,
dead. One friend died of asthma in middle school;
another went to jail, then hanged himself. (Other peo-
ple I spoke with around Penn North and other recov-
ery facilities had similarly traumatic experiences. It
seemed like every second person I met told me they
had been molested as a child, and even more said their
family members had struggled with addiction.)
Kiarra told me she got pregnant by a friend when
she was 12, and gave birth to a boy when she was 13.
Within a year, the baby died unexpectedly, and Kiarra
was so traumatized that she ended up spending more
than a month in a psychiatric hospital. When she
came home, her boyfriend physically and sexually
abused her. He “slapped me so hard, I was seeing
stars,” she said.
She took solace in eating, a common refuge for
victims of abuse. One 2013 study of thousands of
women found that those who had been severely
physically or sexually abused as children had nearly

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 77
double the risk of food addiction. Kiarra ate “everything, anything,” she The way African Americans became trapped in
said, “mostly bad foods, junk food, pizza,” along with chicken boxes—the Baltimore’s poorest—and least healthy—neighbor-
fried-chicken-and-fries combos slung by Baltimore’s carryout joints. hoods mirrors their history in the ghettos of other
At irst, she thought the extra weight looked good on her. Then she started major cities. It began with outright bans on their
feeling fat. Eventually, she said, “it was like, Fuck it. I’m fat.” As her high- presence in certain neighborhoods in the early
school graduation approached, she tried on the white gown she’d bought just 1900s and continued through the 2000s, when pol-
weeks earlier and realized that it was already too tight. icy makers, lenders, and fellow citizens employed
Kiarra didn’t know many college-educated people, but she wanted to go to subtler forms of discrimination.
Spelman, a historically black college in Georgia, and join a sorority. Her fam- In the early 1900s, blacks in Baltimore dispropor-
ily talked her out of applying, she said. Instead, she enrolled in one local col- tionately sufered from tuberculosis, so much so that
lege after another, but she kept dropping out, sometimes to help her siblings one area not far from Penn North was known as the
with their children and other times because she simply lost interest. After “lung block.” In 1907, an investigator hired by local
accumulating $30,000 in student loans, she had only a year’s worth of credits. charities described what she saw in Meyer Court, a
So Kiarra put college on hold and worked at Kmart and as a home health poor area in Baltimore. The contents of an outdoor
aide—solid jobs but, as she likes to say, “not my ceiling.” She longed for a toilet “were found streaming down the center of this
purpose. Sometimes, she had an inkling that she was meant to be an impor- narrow court to the street beyond,” she wrote. The
tant person; she would picture herself giving a speech to an auditorium full smell within one house was “ ‘sickening’ … No provi-
of people. But she remained depressed, stuck, and, increasingly, obese. sion of any kind is made for supplying the occupants
She began doing ecstasy, and, later, downing a pint of vodka a day. She of this court with water.” Yet one cause, the housing
remembers coming to her home-health-aide job drunk one time and leaving investigator concluded, was the residents’ “low stan-
a patient on the toilet. “Did you forget me?” the woman asked, half an hour dards and absence of ideals.”
later. Kiarra broke down crying. When blacks tried to lee to better areas, some
Soon after, she checked into Penn North for her irst try at recovery. This had their windows smashed and their steps smeared
past year’s attempt is her third. with tar. In 1910, a Yale-educated black lawyer
named George McMechen moved into a house in
97 percent black, and half of its families live in a white neighborhood, and Baltimore reacted by
  S A N D T O W N  I S  
poverty. Its homicide rate is more than double that adopting a segregation ordinance that The New York
of the rest of the city, and last year about 8 percent of the deaths there Times called “the most pronounced ‘Jim Crow’ mea-
were due to drug and alcohol overdose. Still, its top killers are heart dis- sure on record.” Later, neighborhood associations
ease and cancer, which African Americans nationwide are more likely to urged homeowners to sign covenants promising
die from than other groups are. never to sell to African Americans.

78 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
For much of the 20th century, the Federal Hous- Penn North’s aging air con-
  A L L  S U M M E R,  
ing Administration declined to insure mortgages ditioners strained against the
for blacks, who instead had to buy homes by signing soupy heat outside. For Kiarra, the irst few months
contracts with speculators who demanded payments at the recovery center felt like boot camp. The staf
that, in many cases, amounted to most of the buyer’s woke the residents before 7 a.m., even if they didn’t
income. (As a result, many black families never reaped have anywhere in particular to be. Kiarra’s days were
the gains of homeownership—a key source of Ameri- packed with therapies: acupuncture in the mornings,
cans’ wealth.) Housing discrimination persisted well meant to help reduce cravings; individual meetings
beyond the Jim Crow years, as neighborhood associa- with peer counselors; Narcotics Anonymous ses-
tions rejected proposals to build low-income housing sions, in which dozens of strangers slumped on metal
in aluent suburbs. In the 1990s, house lippers would folding chairs and told stories of past drug binges.
buy up homes in Baltimore’s predominantly black Once a week, Kiarra would leave her post at the
neighborhoods and resell them to unsuspecting irst- front desk and walk across an empty playground for an
time home buyers at inlated prices by using falsiied appointment with her psychotherapist, Ms. Bea (who
documents. The subsequent foreclosures are a major asked that I not use her full name). Kiarra would climb
reason so many properties in the city sit vacant today. the steep, narrow staircase of Penn North’s clinical
Some of Baltimore’s rowhouses are so long- building, then stop at the landing to catch her breath.
forsaken, they have trees growing through the win- Ms. Bea’s goal was to help Kiarra understand how
dows. These dilapidated homes are in themselves her substance abuse, her weight, and her diicult
harmful to people’s health. Neighborhoods with childhood were interconnected. Like many young
poorly maintained houses or a large number of people in Baltimore, Kiarra had spent her life trying
abandoned properties, for instance, face a high risk to attain ordinary things—love, respect—that seemed
of mouse infestation. Every year, more than 5,000 always to skid beyond her grasp. She wanted male
Baltimore children go to the emergency room for attention, but then she got pregnant. The baby made
an asthma attack—and according to research from her happy, but the baby died. Her siblings started
Johns Hopkins, mouse allergen is the biggest envi- having kids and she loved them, but she was jealous.
ronmental factor in those attacks. She fell into a deep-sink depression. She’d eat a sec-
The allergen, found in mouse urine, travels ond dinner, then get so drunk that she’d scream at her
through the air on dust, and Johns Hopkins research- friends. She’d realize that she was going to wake up
ers have found high levels of it on most of the beds to a blistering hangover and would keep drinking. It
of poor Baltimore kids they have tested. When kids was coming anyway, so why not? “Struggle days,” she
Kiarra lives inhale the allergen, it can spark inlammation and called these times.
in Sandtown, mucus buildup in their lungs, making them cough During one appointment in August, Kiarra told
the Baltimore and wheeze. These attacks can cause long-term Ms. Bea that she had been attending Overeaters
neighborhood
harm: Children with asthma are more likely to be Anonymous meetings by phone. Something another
made famous by
the Freddie Gray
obese and in overall poorer health as adults. Getting member had shared, about why people are some-
protests, where rid of the mice requires sealing up cracks and holes in times reluctant to shed weight, had stuck with her.
heart disease and the house—a process that can cost thousands of dol- “He was saying when you lose the fat, you lose a part
cancer are the lars, given the state of many Baltimore homes. of you,” Kiarra recalled.
leading killers. The mice, of course, are just one symptom of the A few years earlier, she had founded a club for
widespread neglect that can set in once neighbor- plus-size women called Beautiful Beyond Weight,
hoods become as segregated as Baltimore’s are. One with some of her best friends. The goal was to help
study estimated that, in the year 2000, racial seg- overweight women feel better about themselves.
regation caused 176,000 deaths—about as many as They put on fashion shows that she described as
were caused by strokes. “Beyoncé big, but on a Christina Aguilera budget.”
She worried that if she lost too much weight, the
other girls in the club would think she was a hypocrite.
SOME OF BALTIMORE’S ROWHOUSES She decided she would aim to be “slim-thicc”—not
too skinny.
ARE SO LONG-FORSAKEN, THEY HAVE “So imagine if you were a size 14,” Ms. Bea said.
“What would be happening here—with you?”
TREES GROWING THROUGH THE Ms. Bea was trying to help Kiarra see how she
WINDOWS. THEY ARE IN THEMSELVES sometimes uses her size as a form of protection, a
way of making her feel invisible to men, so that she
HARMFUL TO PEOPLE’S HEALTH. could eventually work through her fear.
In Kiarra’s experience, disappearing could be use-
ful. She told me that once, when she was 17, before
she had gotten so big, she met a guy in an online chat
room. She went over to his place, where they watched
TV and started having sex. But then—the skid—his
three friends barged into the room and raped her. She
led, half-dressed, as soon as she could.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 79
“Yeah,” Kiarra said, envisioning herself many sizes smaller. “I wouldn’t properties, allowing old paint to chip and leaded dust
be able to take it.” to accumulate. Some landlords, seeking to avoid the
expense of renovating homes and the risk of tenant
concentrating sometimes, and she thinks lawsuits, refused to rent to families with children,
  K I A R R A  H A S  T R O U B L E  
  the
reason might be that she and her since they would face the greatest risk from lead
brother were exposed to lead from old paint. When Kiarra was 6, her grand- exposure. Poor families feared that if they com-
mother heard that a girl living in another property owned by the same land- plained about lead, they might be evicted.
lord had been hospitalized. She took Kiarra to get tested. The results showed Partly because of Maryland’s more rigorous
that the concentration of lead in her blood was more than six times the level screening, the state’s lead-poisoning rate for chil-
the Centers for Disease Control and Prevention considers elevated—an dren was 15 times the national average in the ’90s;
amount that can irreversibly lower IQ and reduce attention span. Kiarra, too, the majority of the poisoned children lived in the
was hospitalized, for a month. poor areas of Baltimore. In some neighborhoods,
Scientists and industry experts knew in the 19th century that lead paint 70 percent of children had been exposed to lead.
was dangerous. “Lead is a merciless poison,” an executive with a Michigan The city’s under-resourced agencies failed to
lead-paint company admitted in a book in 1892. It “gradually afects the address the problem. Clogged by landlords who
nerves and organs of circulation to such a degree that it is next to impossible hid behind shell companies, Baltimore’s lead-paint
to restore them to their normal condition.” But as late as the 1940s and ’50s, enforcement system had ground to a halt by the
trade groups representing companies that made lead products, including time Kiarra was poisoned. According to Tapping Into
the Lead Industries Association, promoted the use of lead paint in homes The Wire, a book co-authored by Peter L. Beilenson,
and successfully lobbied for the repeal of restrictions on that use. Lead-paint the city’s former health commissioner, Baltimore
companies published coloring books and advised their salesmen to “not for- didn’t bring a single lead-paint enforcement action
get the children—some day they may be customers.” According to The Balti- against landlords in the ’90s. (A subsequent crack-
more Sun, a study in 1956 found that lead-poisoned children in the slums of down on landlords has lowered lead-poisoning rates
Baltimore had six times as much lead in their systems as severely exposed dramatically.)
workers who handled lead for a living. When Kiarra was 14, her family sued their land-
In speeches and publications, Lead Industries Association oicials cast lord for damages, but their lawyer dropped the case
childhood lead poisoning as vanishingly rare. When they did acknowledge because the landlord claimed he had no money and
the problem, they blamed “slum” children for chewing on wood surfaces— no insurance with which to compensate them. Kiarra
“gnaw-ledge,” as Manfred Bowditch, the group’s health-and-safety director, remembers her grandmother not wanting to give up,
called it—and their “ignorant parents” for allowing them to do so. In a letter to demanding of the lawyer, “What do you mean there’s
the Baltimore health department, Bowditch called the lead-poisoned toddlers nothing you can do?”—only to get lost in a tangle of
“little human rodents.” legal rules she didn’t fully understand.
Even after stricter regulations came along, landlords in segregated
neighborhoods—as well as the city’s own public-housing agency—neglected this past August,
  O N   A   H O T   S AT U R D AY  
Kiarra brought her
nieces with her to work and corralled them in the
LIFE EXPECTANCY AT BIRTH IN BALTIMORE front oice. She was babysitting that day, and staing
BY NEIGHBORHOOD was short at the center. The girls climbed restlessly
on the stained oice chairs and under the tables.
Kiarra is close with her family. She spends much
of her free time texting her favorite sisters on her
85–89
cracked cellphone, and she talks to her grandmother
every few days. Any familial strife upsets her deeply:
80–84 She can vividly recount a long list of times her mother
disappointed her. Then again, sometimes she feels like
she’s the one who has let everyone down, with all her
75–79 drinking and dropping out.
Near the end of the day, Kiarra’s cellphone rang.
It was her father, calling to yell at her because she
70–74
hadn’t come to see him recently. “I’ve been busy,”
Kiarra told him.
65–69 When Kiarra was little, and when her father
wasn’t incarcerated, he had provided for his
children—unlike many dads she knew. She’d sought
his approval by researching Islam, his religion, and
trying to reconcile it with the strict Christianity of her
SANDTOWN-
grandmother’s home. A few years ago, she tried to
WINCHESTER AND impress him by joining a tough-seeming social club
HARLEM PARK that turned out to be too much like a gang. (It “wasn’t
a good it,” she told me.)
On some level, she still respected her father. But
2017 NEIGHBORHOOD HEALTH PROFILES/BALTIMORE CITY HEALTH
DEPARTMENT (NO DATA AVAILABLE FOR DETENTION FACILITIES) he had an explosive personality and struggled with
Kiarra hung up, this time for good. Then she wept. “As long as I’m fucked up,
this man is cool, but as soon as I decide I want to get my fucking life together
it’s like …” Her voice trailed of. She turned and told me she wanted to go to
McDonald’s. “McDonald’s is killing me,” she said, “but it’s a special treat.”
She ordered her usual—a McDouble and a McChicken, along with a sweet
tea—and waited silently amid the beeping of the cash registers.

people I met at Penn North were optimistic and sur-


  MOST OF THE  
rounded by iercely loyal friends. But their lives also
seemed, like Kiarra’s, unrelentingly stressful. Between the hugs and hand-
shakes, I heard a lot of trepidation. I have to move again … Where will I go?
EVEN AMONG Will I get this job at Target? Will I ever walk again? Will I get to eat today?

PEOPLE MAKING Research shows that this kind of day-in, day-out worry can ravage a per-
son’s health. Certain stressful experiences—such as living in a disordered,
$175,000 A impoverished neighborhood—are associated with a shortening of the telo-
meres, structures that sit on the tips of our chromosomes, which are bundles
YE AR OR MORE , of DNA inside our cells. Often compared to the plastic caps on the ends of
shoelaces, telomeres keep chromosomes from falling apart. They can also
BL ACKS ARE be a measure of how much a body has been ground down by life.

MORE LIKELY Some researchers think stress shrinks telomeres, until they get so short
that the cell dies, hastening the onset of disease. Diferent kinds of prolonged
TO SUFFER emotional strain can afect telomeres. In one study, mothers who had high
stress levels had telomeres that were as short as those of a person about a
FROM CERTAIN decade older. Another study found that children who spent part of their
childhood in Romanian orphanages had telomeres that shortened rapidly.
DISE ASES THAN Arline T. Geronimus, an expert on health disparities at the University of

WHITES ARE . Michigan, has found that African Americans have more stress-related wear
and tear in their bodies than white people do, and the diference widens with
age. By measuring telomere length in hundreds of women, Geronimus esti-
depression and addiction. Kiarra told me he taught her mated that black women were, biologically, about seven and a half years
what men are supposed to be: ierce protectors who older than white women of the same age.
sometimes turn their wrath on the women in their lives. Unrelenting stress also afects our daily behaviors: Stress causes some
Kiarra usually tried to see her father’s outbursts as people to eat more, especially calorically dense foods, and to sleep less.
a cry for help. But today, she decided to confront him. On average, African Americans get about 40 minutes less sleep each night
Their conversation escalated as they accused each than white people do. Among women in one recent study, poor sleep alone
other of failing at fatherhood and daughterhood. explained more than half the racial disparity in cardiovascular-disease risk.
“How many of my plays have you been to?,” Living in a dangerous neighborhood like Sandtown requires a vigilance
Kiarra demanded. that can lood the body with adrenaline and cortisol. These hormones are
Her father launched into a tirade. “I will come for supposed to kick in only long enough for us to get away from an immediate
your fucking dumb ass!,” I overheard him yell at one threat. If they trickle through us constantly, they can raise the risk of heart
point. “You going to respect me!” disease and compromise the body’s immune system.
“Respect works both ways,” Kiarra said. “I’m not These kinds of changes in body chemistry aren’t limited to people living
that little girl that’s gonna let you slap the shit out of me.” in poverty. Even well-of black people face daily racial discrimination, which
What bothered Kiarra most was that her father had can have many of the same biological efects as unsafe streets. Thomas
never hit his other daughter that way, so why her? Why LaVeist, the dean of Tulane’s School of Public Health and Tropical Medicine,
did it feel like he was always rejecting her? (Her father has found, for example, that even among people earning $175,000 a year or
later conirmed that he had hit her as a child, saying, more, blacks are more likely to sufer from certain diseases than whites are.
“Discipline is a must, whatever form you choose.”) In an emerging ield of research, scientists have linked stress, including
As he continued screaming—“I’m gonna put your from prejudice, to compounds called methyl groups attaching to our genes,
fuckin’ head in the dirt”—Kiarra’s eyes glazed over. like snowlakes sticking to a tree branch. These methyl groups can cause
“Death gotta be better than here,” she said. genes to turn on or of, setting disease patterns in motion. Recently, a study
She hung up, then wiped away tears. Just today, linked racial discrimination to changes in methylation on genes that afect
he had called her at 12:30 a.m., 3:48 a.m., 7:47 a.m., schizophrenia, bipolar disorder, and asthma.
11:24 a.m., 3:33 p.m., and 4:44 p.m. One time when she Several studies also show that experiencing racism might be part of the
didn’t answer the phone, Kiarra said, he showed up in reason black women are about 50 percent more likely than white women to
person at Penn North. have premature babies and about twice as likely to have low-birth-weight
Her father called back, rambling less coherently babies. Researchers think the stress they experience might cause the body
than before. “How much of my life did you spend to go into labor too soon or to mount an immune attack against the fetus.
incarcerated?,” Kiarra asked him. When she was little, This disparity, too, does not appear to be genetic: Black women from sub-
she would go out hustling with him. “I was 14 fucking Saharan Africa and the Caribbean are less likely to have preterm births than
years old seeing dead fucking bodies, and you’re talking African American women are, possibly because they’ve spent less time living
about where the fuck did this drinking shit come from?” in America’s racist environment.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 81
the fall, Kiarra kept her doctor
  T H RO U G H O U T  
appointments, and she began
working out at the small gym at Penn North, placing a
picture of Chrissy Lampkin, the curvaceous girlfriend
of the rapper Jim Jones, on her treadmill as motivation.
But Kiarra still wasn’t losing much weight. Like most
Americans, she got advice from her friends on what
to eat—but that advice at times proved confusing and
contradictory. She tried a boiled-egg diet, which left her
with hunger pangs and a lot of leftover eggs in the fridge.
She went seven days without meat but wound up eating
more starches, which sent her blood sugar soaring.
One bright day in late September, Kiarra returned
to Bon Secours to see Ebony Hicks, a behavioral-
health consultant who, like Kiarra’s doctor, works
through Health Care for the Homeless, a Baltimore
nonproit that cares for the very poor. Hicks began by
asking Kiarra what her goal was. Kiarra said getting ONE REASON COLLEGE GRADUATES
down to an even 200 pounds “would be awesome.”
Her weight remained, stubbornly, about 150 pounds
LIVE LONGER, RESEARCHERS BELIEVE,
higher than that. But she stayed optimistic, writing
down Hicks’s aphorisms about needing to be patient
IS THAT EDUCATION ENDOWS
and not expecting immediate results—“Anything over- PEOPLE WITH THE SENSE THAT THEY
night usually lasts about a night!”—in a notebook she’d
brought with her. CONTROL THEIR OWN DESTINY.
Gently, Hicks asked Kiarra what she had eaten
that day. one of the few luxuries around.
“French fries,” Kiarra said. Predominantly black neighborhoods tend to become what researchers
“All you’ve had is french fries?,” Hicks asked. call “food swamps,” or areas where fast-food joints outnumber healthier
“Mm-hmm.” options. (Food deserts, by contrast, simply lack grocery stores.) One study
It was 3:30 in the afternoon. in New York found that as the number of African Americans who lived in
They walked to a room across the hall, and Kiarra a given area increased, so did the distance to the nearest clothing store,
stepped onto a scale. pharmacy, electronics store, oice-supply store. Meanwhile, one type of
“I gained two pounds,” she said quickly, “so now establishment drew nearer: fast-food restaurants.
I’m depressed. I eat too much.” That’s not a coincidence. After the riots of the 1960s, the federal govern-
“We have to work on getting you more regularly ment began promoting the growth of small businesses in minority neigh-
eating throughout the day,” Hicks said. borhoods as a way to ease racial tensions. “What we need is to get private
Kiarra asked whether “detox tea,” something enterprise into the ghetto, and put the people of the ghetto into private enter-
she’d heard about from a friend, was healthy. prises,” President Richard Nixon said around the time he created the Oice of
“You can detox with lots of iber-illed vegetables,” Minority Business Enterprise, in 1969. As Chin Jou, a senior lecturer at the Uni-
Hicks said. versity of Sydney, describes in her book, Supersizing Urban America, fast-food
“What’s that?,” Kiarra asked. companies were some of the most eager entrants into this “ghetto” market.
Hicks pulled up a web page describing fruits and veg- Fast-food restaurants spent the next few decades “rushing into urban mar-
etables that contain iber. She listed them of one by one. kets,” as one Detroit News report put it, seeking out these areas’ “untapped
Would Kiarra eat avocados? labor force” and “concentrated audience.” In the 1990s, the federal govern-
No. ment gave fast-food restaurants inancial incentives to open locations in inner
Coconut? Also no. cities, including in Baltimore. The urban expansion made business sense.
“I do eat berries,” Kiarra said. “Let’s put that “The ethnic population is better for us than the general market,” Sidney Felten-
down.” Kiarra doesn’t know why she dislikes so stein, Burger King’s executive vice president of brand strategy, explained to
many fruits and vegetables. Her grandmother cooked the Miami Herald in 1992. “They tend to have larger families, and that means
healthy meals, putting turkey in big pots of greens for larger checks.” (Supermarket chains didn’t share this enthusiasm; in part
lavor. She had a rule that you could never leave the because the widespread use of food stamps causes an uneven low of custom-
table without eating your vegetables. Kiarra would ers throughout the month, they have largely avoided expanding in poor areas.)
fall asleep at the table. Fast-food executives looked for ways to entice black customers. Burger
Hicks gamely pressed on. “Peas? You like peas?” King made ads featuring Shaft. KFC redecorated locations in cities like Bal-
“I think I’m going to throw up,” Kiarra said, grimacing. timore to cater to stereotypically black tastes, and piped “rap, rhythm and
“Chickpeas,” Hicks ofered. “You ever ate hummus?” blues, and soul music” into the restaurants, Jou writes. “Employees were
“What is hummus?” given new Afrocentric uniforms consisting of kente cloth dashikis.” A study
from 2005 found that TV programs aimed at African Americans feature
has long been Kiarra’s legal more fast-food advertisements than other shows do, as well as more com-
  F R I E D  F O O D   
high—cheap, easily acquired, mercials for soda and candy. Black children today see twice as many soda
something to brighten the gloomiest day. It is also and candy ads as white children do.

82 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
The marketing and franchising onslaught worked, When Kiarra felt especially adrift, she would visit
and the diets of low-income people changed dramati- Steve Dixon, Penn North’s director, in his tiny oice at
cally. Before the rise of fast food and processed foods, the end of the hall, and ask him for advice on inding her
many low-income black families grew their own food purpose. He would tell her to pray and meditate. “When
and ate lots of grains and beans. In 1965, one study you pray, it’s like you’re talking to God,” Kiarra told me
found, poor and middle-income blacks ate healthier— once. “But when you meditate, it’s God talking to you.”
though often more meager—diets than rich whites In November, some combination of prayer, medi-
did. But over the next few decades, the price of meat, tation, and research led Kiarra to enroll in a medical-
junk food, and simple carbohydrates plummeted, assistant training program. The class added another
while the price of vegetables rose. By the mid-’90s, $7,000 to her student-loan debt, but Kiarra seemed
28 percent of African Americans were considered by to thrive in it, and a few weeks before Christmas,
the U.S. Department of Agriculture to have a “poor” she was excitedly planning her post–Penn North
diet, compared with just 16 percent of whites. life. Once she had her medical-assistant certiicate
in hand, she would move to Philadelphia, get a job
Vocational-Technical High School, at Temple University, and take classes to become a
  AT   C A R V E R      
which Kiarra and Freddie Gray registered nurse. Eventually, she hoped to become
attended at the same time, only about a third of a nursing professor. That future held everything she
students go on to enroll in college—yet another fac- wanted: helping people, being a leader, making her
tor that could be contributing to the area’s low life own money, having her own place.
expectancy, given that college graduates outlive Feeling chipper, she decided to browse the wigs at
high-school dropouts in every racial category. a nearby store, stroking the hairpieces and whisper-
One reason college graduates live longer, ing to the best ones that she would be back for them
researchers believe, is that education endows people on payday. She had a new reason to get dolled up: a
with the sense that they control their own destiny. truck driver, “ine as wine” and with no kids—and,
Well- educated people seek out more nutritional accordingly, no messy entanglement with another
information because they’ve been told they can woman. She tried to boss him around, but he told
achieve anything—why not perfect health, too? her to mind her own business, and she kind of liked
Kiarra, by contrast, wasn’t yet sure what she could that. His birthday was approaching, and she wanted
Kiarra some- accomplish. She wanted to live up to an image in her to take him someplace fancy. She would wear a black
times asks mind of a “ly, crazy, daring, dream-chasing girl,” but dress, and he would wear a black suit.
Steve Dixon, she cycled between getting excited about new possi- To help pay for everything, Kiarra decided to reg-
the director of
bilities and being lattened by setbacks. Sometimes, ister as a Lyft driver. All that was required was a $250
Penn North,
for advice
she would dream of turning Beautiful Beyond Weight deposit; she began calling around to diferent rela-
on how to into a business—one that would sell T-shirts and caps tives to raise the money.
find her pur- with empowering messages for plus-size women. But Twenty-seventeen, she thought, had been her
pose in life. she wasn’t really sure how to do that. best year yet.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 83
a bitter cold settled
  A  F E W  W E E K S  L AT E R ,    
through the East
Coast, and Kiarra’s sunny mood had faded. Things
had ended with the truck driver over some mean
Facebook posts and the fact that he’d lied to her
about not having kids. She was also reconsidering
her plans for the future, now thinking that instead
of setting her sights on Temple, she should focus on
graduating and inding a job—any job—that would
pay well enough and provide insurance that would
cover her extensive health-care needs. Her grand-
mother said driving for Lyft in Baltimore was too
dangerous. She might not move to Philly after all.
But a new opportunity presented itself. Because
of a change in her insurance plan, Kiarra had to
switch doctors. Right away, her new doctor asked
her whether she had considered bariatric surgery.
Kiarra said she was scared of the complications, such KIARRA FIGURED THAT IF SHE REALLY
as digestive problems and infections, but the doctor
reassured her that complications are rare. She was
WANTED TO HAVE A SUCCESSFUL
interested in the gastric sleeve, a procedure that
would dramatically reduce the size of her stomach,
PLUS-SIZE CLOTHING BRAND,
causing hormonal changes that would help her lose SHE’D AT LEAST HAVE TO LIVE LONG
much of her body fat.
Kiarra still felt conlicted about losing her identity ENOUGH TO SEE IT HAPPEN.
as an overweight woman. She couldn’t relate to the
people on the Overeaters Anonymous calls who said Her new status as the child’s guardian meant that her stay at Penn North
they hated their bodies. She liked hers. “People say, could be extended, through some alchemy of program deinitions, for nearly
‘Hey, you’re fat,’ ” she said. “And I’m like, ‘That’s obvi- another year. Staying on would mean cheap housing for Kiarra and Brook-
ous.’ ” But she was motivated by her diabetes—which lynn, two people who desperately needed it.
was already causing her vision to blur and her feet With that settled, Kiarra turned her attention to the six-month process of
to tingle—along with the looming threat of other “fat hoop-jumping that was required to qualify for the gastric-sleeve surgery. The
diseases,” as she called them, frightening ones like irst pre-op class was an hour and a half long and took place at a hospital 30
heart failure. She igured that if she really wanted to minutes from Penn North. Kiarra thought the time commitment seemed
have a successful plus-size clothing brand, she’d at excessive; with a smirk, she wondered aloud why the doctors couldn’t just tell
least have to live long enough to see it happen. her and the other patients, “Y’all fat. We gonna cut you up.”
She decided on the spot to go forward with the sur- But the doctors needed Kiarra to understand that the surgery was not
gery, worried that she might change her mind other- something to take lightly. To qualify, she would have to get her sleep apnea
wise. She signed up for the mandatory pre-op classes and diabetes under control. She would have to keep a food journal, submit to
that prepare participants to eat just half a cup of food behavioral evaluations, write an essay explaining why she no longer wanted
for every meal, at least initially, after the surgery. to be morbidly obese. For the rest of her life, she’d need to wait 30 minutes
Her mother was nervous, but her sisters were all for between eating a meal and drinking a beverage. When one of Kiarra’s class-
it. Her grandmother told her to put it in God’s hands. mates said that after the surgery, eating too much would cause you to get
violently sick for an hour, Kiarra recoiled a little.
Kiarra had orga- All of the rules and obligations seemed more intense than Kiarra had
  E A R L I E R  T H AT  M O N T H ,  
nized a birthday expected. “Six months, you’re going on like 16 appointments,” she said.
party for her 2-year-old niece, Brooklynn, in Penn “Whoo, that’s a lot.” Given all she had to contend with, I wondered whether she
North’s community room, decking out the dingy would end up meeting the requirements—and, given the stakes, what might
yellow walls with pink balloons and ribbons. Within happen to her if she didn’t.
a few weeks, it was decided that Kiarra would gain Tony Conn, a Penn North stafer with whom Kiarra is close, calls her a
custody of Brooklynn for a while so that Kiarra’s sis- “wonderful, brilliant person.” Early on in my reporting, he told me her biggest
ter could go back to get her high-school diploma. law is that she sometimes doesn’t see things through to the end. “As soon as
Kiarra was happy with this arrangement—she [something] looks like it’s gonna come to light, she’s like, ‘Okay, I did that. So
already sometimes referred to Brooklynn as her let’s ind something else,’ ” he said.
“daughter-girl”—and she began to see Brooklynn as But lately, Kiarra had shown a new sense of calm and dedication. One day
a reason to stay on track. Juggling coursework and while she worked the front desk, an older man lirted with her as he signed
single parenthood exhausted her at times, but she the attendance sheet.
wanted to be the successful role model for Brooklynn “When you look in the mirror,” he said, “and see how beautiful you are, what
that she never had herself. In the chatty toddler who do you say to yourself?”
loved dress-up and Moana, Kiarra had found, if not “We’ve come a long way,” she said quietly. “Let’s stay there.”
her purpose, at least a purpose. “It feels like the Earth
is full, you know?” she told me one day this spring. Olga Khazan is a staf writer at The Atlantic.

84 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
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FOR ALL

Carolinas HealthCare System is


SPONSOR CONTENT – MARCH ON WASHINGTON FILM FESTIVAL

Witnessing From the 1947 Partition of India

History
to the 1963 March on Washington

By Riddhi Sarkar

hen Cassandra Joseph was growing up, her Listening to Joseph, I could not help thinking about some

W family never spoke about the fact that her an-


cestors had been slaves or that the family was
living in a segregated America. In her home, there was com-
similarities between her story and that of my own grand-
mother Priti Basu.

When my grandmother was four years old, her family fled its
plete silence on the topics of slavery and the systemic
hometown of Bandar, in the Chittagong region that is now
oppression faced by African Americans for generations.
part of Bangladesh, to Kolkata, India, to escape riots and re-
But by the time Joseph got word that Dr. Martin Luther King ligious and political tension after India’s independence from
Jr. was coming to her hometown in 1963, she was 21 years Great Britain, in 1947. Their first six months were spent at a
old and had come to understand the truth about her family government refugee camp, after which the family settled
history. She knew she had to drop everything and go. down in the outskirts of Kolkata. Although it proved dif-
ficult to start a new life from scratch, her family was lucky
As soon as she started recounting to me what happened
that they were able to have made it safely across the border.
in Washington, D.C., on August 28 of that year—which she
Her uncle crossed the border in 1947 on a train on which he
recalled was a bright and sunny day—the hint of excitement
and one other passenger were the lone survivors after all
in her voice was unmistakable. She told me how glad she
the Hindus aboard were murdered. My grandmother told
was that she decided to leave work that day to participate in
me that he had been able to escape by hiding in the bath-
the now famous March on Washington for Jobs and Free-
room of the train.
dom. She recalled Mary Travers from the American folk
group Peter, Paul, and Mary accidentally stepping on her When the Indian subcontinent was broken apart during
foot just before the trio’s onstage performance; the crowd the 1947 partition of India, it marked an upheaval across
singing “We Shall Overcome” in unison; seeing small chil- the region, with many families having to leave their homes
dren in strollers and on the backs of their parents. overnight as new borders were hastily drawn along religious
lines. India was finally free from British rule, but the event
The memories of the day are forever etched in her mind,
led to one of the largest mass migrations in history and left
as they are for many of the ordinary people who sacrificed
a scar on the lives of many. Yet there was a silence around
careers, families, and even their personal safety to make
personal aspects of the topic in affected families for years
up the massive effort that is now often reduced to a few
afterward. Like Joseph’s family, my grandmother’s house-
speeches by a few famous people. Highlighting the con-
hold never discussed their family history at home. Even my
tributions of ordinary citizens—the students who risked
mother knew little about her mother’s migration experience
being kicked out of school to demonstrate on campus, the
while she was growing up. My grandmother only opened up
canvassers who wore the soles of their shoes thin while
to me when I implored her to tell me more.
trying to register voters—was the goal of the 2017 March
on Washington Film Festival, which every year strives to tell My grandmother, despite being one of the smartest students
the stories of the untold events and unsung heroes of the at her school, had to give up her education and abandon
civil-rights era. her dreams of becoming a doctor because her family had
SPONSOR CONTENT – MARCH ON WASHINGTON FILM FESTIVAL

very little after they migrated as refugees. Taking care of the here must be a reason my grandmother never spoke
home and getting her married became bigger priorities T much about her history until her own granddaughter
for her family than paying for her education, thus cutting was 18—and why Joseph’s family also remained silent
short her career aspirations. I also learned about the strug- about its own. A deeply rooted pain caused by history
gles her parents faced in keeping her and her siblings safe that I can only imagine sometimes stops us from having a
among the violence caused by the partition of India. In the conversation about it. But events like the March on Wash-
days prior to the family’s migration, her mother would stay ington Film Festival are powerful agents in sparking intel-
awake holding her every night, waiting for daylight at a lectual and moral curiosity. In rekindling conversation about
Muslim neighbor’s home since their own was at risk of be- the civil-rights movement and the sacrifices people made
ing burned down—just like many other Hindu homes in the during those seminal events in our nation’s history, we
neighborhood—in the religiously mo- create a space for dialogue that is
tivated riots. To know that even in the crucial to understanding where we
midst of the tension between Hindus are today and to shaping our future
and Muslims there were individuals No matter how painful as a fair and just society. These con-
who looked beyond religion to help versations can start right at home,
it is to talk about the past,
those in need gives me hope about simply by questioning where we
creating a more peaceful world by if we remain silent and come from. No matter how painful it
fighting the tension that still exists do not dig deep, the voices is to talk about the past, if we remain
among religions. If tolerance, love, silent and do not dig deep, the voices
compassion, and open-mindedness
of our ancestors will of our ancestors will be forever lost,
could transcend religious dogmas be forever lost. and with them a chance to create
then, they certainly can now. and chronicle an accurate represen-
tation of history.
While speaking with my grandmother,
I learned that her father had put his medical career second While it is essential to pay tribute to the work of prominent
and activism first, often joining local activists in protesting leaders who advanced civil rights, we must never stop
the nearly 200 years of British colonization of India. Inciden- seeking more witnesses of history and voices of unsung
tally, it is that fight for independence—particularly Mahatma heroes—people who were less famous than King or Gand-
Gandhi’s civil-disobedience strategy used to free India from hi but who did their part in our societal march to equality
the shackles of British imperialism—that inspired Martin for all. If we do not recognize the contributions of Cassandra
Luther King Jr. to use that very tactic in the American civil- Joseph, of my grandmother Priti Basu and her parents, we
rights movement years later. are ignoring the fullness of history and thereby the op-
portunity to learn from the work not just of icons but of
y grandmother told me all of this during the summer
M after my 18th birthday. After my grandparents were
everyday people like you and me.

married and started a family, they made numerous sacrifices I do not need expensive tripods or fancy recording equip-
to ensure that their children would have more opportunities ment to preserve an important story; a genuine curiosity to
than they had. As I sat across the table from my grandmother learn and ask critical questions is a great first step. Anyone
in Kolkata two years ago, just as I was preparing to take off to can be a storyteller, and that is a gift we can give to honor
attend American University, in Washington, D.C., I made sure the legacy of the past and, in the process, contribute to a
this story of her sacrifices—the story of my family—would be better future.
properly preserved. I turned on my iPhone’s video recorder
one evening before leaving, trying my best to balance the
phone on a stack of old newspapers and books. Then, with
pen and paper in hand and a determination to ask long-bur-
Riddhi Sarkar is a student at American
ied questions that would help me get to the bottom of my
University. Her essay, “Witnessing
family’s migration story, I dived right into interviewing her.
History,” was a winner of the Freedom’s
Seeing how grateful my grandmother was to have her story
Children Student Journalists
shared was an unforgettable moment. By logging her story
Competition for the 2017 March on
and those of other witnesses, in my role as a citizen historian
Washington Film Festival.
for the 1947 Partition Archive, I am part of a movement that
adds to the body of knowledge on the partition of India by
gleaning witness accounts.
After a dark history in which transgender kids were routinely ignored,
“repaired,” or persecuted, a new protocol of social and physical transition has
emerged. For teens who experience persistent gender dysphoria, this protocol
can provide profound relief from suffering. For some kids, however, gender
dysphoria is temporary. And the effects of transitioning can be permanent.

BY JESSE SINGAL
PHOTOGRAPHS BY MACIEK JASIK

88 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
| TH E H E ALTH REP O RT |

YO U R C H I L D S AY S S H E ’ S T R A N S .

SHE WANTS

H O R M O N E S AND S U R G E RY.

SHE’S 13.
L A I R E I S A 1 4 -Y E A R- O L D G I R L with short To Claire’s parents, her anguish seemed to come
auburn hair and a broad smile. She lives outside Phila- out of nowhere. Her childhood had been free of gen-
delphia with her mother and father, both professional der dysphoria—the clinical term for experiencing a
scientists. Claire can come across as an introvert, but powerful sense of disconnection from your assigned
she quickly opens up, and what seemed like shyness sex. They were concerned that what their daughter
reveals itself to be quiet self-assuredness. Like many had self-diagnosed as dysphoria was simply the tra-
kids her age, she is a bit overscheduled. During the vails of puberty.
course of the evening I spent with Claire and her As Claire passed into her teen years, she continued
mother, Heather—these aren’t their real names— to struggle with mental-health problems. Her parents
theater, guitar, and track tryouts all came up. We found her a therapist, and while that therapist worked
also discussed the fact that, until recently, she wasn’t on Claire’s depression and anxiety—she was waking
certain she was a girl. up several times a night to make sure her alarm clock
Sixth grade had been diicult for her. She’d strug- was set correctly—she didn’t feel qualiied to help her
gled to make friends and experienced both anxiety patient with gender dysphoria. The therapist referred
and depression. “I didn’t have any self-conidence the family to some nearby gender-identity clinics that
at all,” she told me. “I thought there was something ofered transition services for young people.
wrong with me.” Claire, who was 12 at the time, also Claire’s parents were wary of starting that process.
felt uncomfortable in her body in a way she couldn’t Heather, who has a doctorate in pharmacology, had
quite describe. She acknowledged that part of it had begun researching youth gender dysphoria for herself.
to do with puberty, but she felt it was more than the She hoped to better understand why Claire was feel-
usual preteen woes. “At irst, I started eating less,” ing this way and what she and Mike could do to help.
she said, “but that didn’t really help.” Heather concluded that Claire met the clinical crite-
Around this time, Claire started watching YouTube ria for gender dysphoria in the DSM-5, the American
videos made by transgender young people. She was Psychiatric Association’s diagnostic manual. Among
particularly fascinated by MilesChronicles, the chan- other indications, her daughter clearly didn’t feel like
nel of Miles McKenna, a charismatic 22-year-old. His a girl, clearly wanted a boy’s body, and was deeply
1 million subscribers have followed along as he came distressed by these feelings. But Heather questioned
out as a trans boy, went on testosterone, got a double whether these criteria, or much of the information
mastectomy, and transformed into a happy, healthy she found online, told the whole story. “Psychologists
young man. Claire had discovered the videos by acci- know that adolescence is fraught with uncertainty
dent, or rather by algorithm: They’d showed up in her and identity searching, and this isn’t even acknowl-
“recommended” stream. They gave a name to Claire’s edged,” she told me.
discomfort. She began to wonder whether she was Heather said most of the resources she found for
transgender, meaning her internal gender identity parents of a gender-dysphoric child told her that if
didn’t match the sex she had been assigned at birth. her daughter said she was trans, she was trans. If
“Maybe the reason I’m uncomfortable with my body is I’m her daughter said she needed hormones, Heather’s
supposed to be a guy,” she thought at the time. responsibility was to help her get on hormones. The
Claire found in MilesChronicles and similar You- most important thing she could do was airm her
Tube videos a clear solution to her unhappiness. “I daughter, which Heather and Mike interpreted as
just wanted to stop feeling bad, so I was like, I should meaning they should agree with her declarations that
just transition,” she said. In Claire’s case, the irst step she was transgender. Even if they weren’t so certain.
would be gaining access to drugs that would halt
puberty; next, she would start taking testosterone to S H E A T H E R WA S S E A R C H I N G for
develop male secondary sex characteristics. “I thought
that that was what made you feel better,” she told me.
A answers, Claire’s belief that she should
transition was growing stronger. For
In Claire’s mind, the plan was concrete, though months, she had been insistent that she wanted both
neither Heather nor her husband, Mike, knew about testosterone and “top surgery”—a double mastec-
any of it. Claire initially kept her feelings from her tomy. She repeatedly asked her parents to ind her
parents, researching steps she could take toward doctors who could get her started on a path to physi-
transitioning that wouldn’t require medical inter- cal transition. Heather and Mike bought time by
ventions, or her parents’ approval. She looked into telling her they were looking but hadn’t been able to
ways to make her voice sound deeper and into bind- ind anyone yet. “We also took her kayaking, played
ers to hide her breasts. But one day in August 2016, more board games with her and watched more TV
Mike asked her why she’d seemed so sad lately. She with her, and took other short family trips,” Heather
explained to him that she thought she was a boy. recalled. “We also took away her ability to search
This began what Heather recalls as a complicated online but gave her Instagram as a consolation.”
time in her and her husband’s relationship with their They told her they realized that she was in pain, but
daughter. They told Claire that they loved and sup- they also felt, based on what they’d learned in their
ported her; they thanked her for telling them what research, that it was possible her feelings about her
she was feeling. But they stopped short of encourag- gender would change over time. They asked her to
ing her to transition. “We let her completely explore start keeping a journal, hoping it would help her
this on her own,” Heather told me. explore those feelings.

90 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Claire humored her parents, even as her frustration But when it comes to the question of physical inter-
with them mounted. Eventually, though, something ventions, this era has also brought fraught new chal-
shifted. In a journal entry Claire wrote last November, lenges to many parents. Where is the line between
she traced her realization that she wasn’t a boy to one not “feeling like” a girl because society makes it dif-
key moment. Looking in the mirror at a time when she icult to be a girl and needing hormones to alleviate
was trying to present in a very male way—at “my baggy, dysphoria that otherwise won’t go away? How can
uncomfortable clothes; my damaged, short hair; and parents tell? How can they help their children gain
my depressed-looking face”—she found that “it didn’t access to the support and medical help they might
make me feel any better. I was still miserable, and I need, while also keeping in mind that adolescence is,
still hated myself.” From there, her distress gradually by deinition, a time of fevered identity exploration?
began to lift. “It was kind of sudden when I thought: There is no shortage of information available for
You know, maybe this isn’t the right answer—maybe it’s parents trying to navigate this diicult terrain. If you
something else,” Claire told me. “But it took a while to read the bible of medical and psychiatric care for
actually set in that yes, I was deinitely a girl.” transgender people—the Standards of Care issued by
Claire believes that her feeling that she was a boy the World Professional Association for Transgender
stemmed from rigid views of gender roles that she Health (WPATH)—you’ll find an 11-page section
had internalized. “I think I really had it set in stone called “Assessment and Treatment of Children and
what a guy was supposed to be like and what a girl Adolescents With Gender Dysphoria.” It states that
was supposed to be like. I thought that if you didn’t while some teenagers should go on hormones, that
follow the stereotypes of a girl, you were a guy, and if decision should be made with deliberation: “Before
you didn’t follow the stereotypes of a guy, you were a any physical interventions are considered for adoles-
girl.” She hadn’t seen herself in the other girls in her cents, extensive exploration of psychological, family,
middle-school class, who were breaking into cliques and social issues should be undertaken.” The Ameri-
and growing more gossipy. As she got a bit older, she can Psychological Association’s guidelines sound a
found girls who shared her interests, and started to similar note, explaining the
feel at home in her body. beneits of hormones but also
Heather thinks that if she and Mike had heeded noting that “adolescents can
the information they found online, Claire would become intensely focused on
have started a physical transition and regretted it their immediate desires.” It
later. These days, Claire is a generally happy teenager goes on: “This intense focus How can parents
whose mental-health issues have improved markedly. on immediate needs may cre-
She still admires people, like Miles McKenna, who ate challenges in assuring that
get children
beneited from transitioning. But she’s come to real- adolescents are cognitively the support
ize that’s just not who she happens to be. and emotionally able to make they might need
life-altering decisions.”
H E N U M B E R O F self-identifying trans The leading professional while keeping
T people in the United States is on the rise. In
June 2016, the Williams Institute at the UCLA
organizations ofer this guid-
ance. But some clinicians
in mind that
adolescence is,
School of Law estimated that 1.4 million adults in are moving toward a faster
the U.S. identify as transgender, a near-doubling process. And other resources, by definition,
of an estimate from about a decade earlier. As of including those produced by a time of identity
2017, according to the institute, about 150,000 teen- major LGBTQ organizations,
agers ages 13 to 17 identiied as trans. The number of place the emphasis on accep-
exploration?
young people seeking clinical services appears to be tance rather than inquiry. The
growing as well. A major clinic in the United King- Human Rights Campaign’s
dom saw a more than 300 percent increase in new “Transgender Children &
referrals over the past three years. In the U.S., where Youth: Understanding the
youth gender clinics are somewhat newer—40 or so Basics” web page, for example, encourages parents
are scattered across the country—solid numbers are to seek the guidance of a gender specialist. It also
harder to come by. Anecdotally, though, clinicians asserts that “being transgender is not a phase, and
are reporting large upticks in new referrals, and wait- trying to dismiss it as such can be harmful during a
ing lists can stretch to ive months or longer. time when your child most needs support and valida-
The current era of gender-identity awareness has tion.” Similarly, parents who consult the pages tagged
undoubtedly made life easier for many young people “transgender youth” on GLAAD’s site will ind many
who feel constricted by the sometimes-oppressive articles about supporting young people who come out
nature of gender expectations. A rich new language as trans but little about the complicated diagnostic
has taken root, granting kids who might have felt and developmental questions faced by the parents of
alone or excluded the words they need to describe a gender-exploring child.
their experiences. And the advent of the internet has HRC, GLAAD, and like-minded advocacy groups
allowed teenagers, even ones in parts of the country emphasize the acceptance of trans kids for under-
where acceptance of gender nonconformity contin- standable reasons: For far too long, parents, as well
ues to come far too slowly, to ind others like them. as clinicians, denied the possibility that trans kids

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 91
and teens even existed, let alone that they should be Claire’s parents, they may be convinced that their
allowed to transition. Many such organizations are child is in pain, but also concerned that physical
primarily concerned with raising awareness and cor- transition is not the solution, at least not for a young
recting still-common misconceptions. person still in the throes of adolescence.
A similar motive seems to animate much of the
media coverage of transgender young people. Two E A R E S T I L L in the earliest stages of
genres of coverage have emerged. Dating back at
least to the 1993 murder of the Nebraska 21-year-old
W understanding how physical transitioning
afects dysphoric young people. While the
Brandon Teena, which inspired a documentary as speciics depend on your child’s age, and can vary
well as the ilm Boys Don’t Cry, a steady stream of hor- from case to case, the transition process for a persis-
ror stories has centered on bullying, physical assault, tently dysphoric child typically looks something like
and suicide—real risks that transgender and gender- the following. First, allow your child to transition
nonconforming (TGNC) young people still face. socially: to adopt the pronouns and style of dress of
More recently, a wave of success stories has their authentic gender, and to change their name if
appeared. In many of these accounts, kids are lost, they wish. As your child approaches adolescence, get
confused, and frustrated right up until the moment them puberty-blocking drugs, because developing
they are allowed to grow their hair out and adopt a the secondary sex characteristics of their assigned
new name, at which point they inally become their sex could exacerbate their gender dysphoria. When
true self. Take, for example, a Parents.com article they reach their teen years, help them gain access
in which a mother, writing to the cross-sex hormones that will allow them to
pseudonymously, explains develop secondary sex characteristics in line with
that she struggled with their gender identity. (Until recently, hormones were
her child’s gender- identity typically not prescribed until age 16; it’s now more
issues for years, until inally common for 15- and 14-year-olds, and sometimes
For many turning to a therapist, who, even younger kids, to begin hormone therapy.)
young people after a 20-minute evaluation, In the United States, avoiding puber ty became
in early studies, pronounced the child trans. an option only a little more than a decade ago, so
Suddenly, everything clicked researchers have just begun tracking the kids
transitioning into place. The mother writes: engaged in this process, and we don’t yet have
appears to “I looked at the child sitting comprehensive data about their long-term out-
have greatly between my husband and comes. Most of the data we do have involve kids
me, the child who was smil- who socially transitioned at an early age, but who
alleviated their ing, who appeared so happy, hadn’t yet physically transitioned. The information
dysphoria. who looked as if someone comes from a University of Washington researcher
But it’s not finally saw him or her the
way she or he saw him or
named Kristina Olson. Olson is the founder of the
TransYouth Project, which is following a cohort of
the answer herself.” In a National Geo- about 300 children for 20 years—the longest such
for everyone. graphic special issue on gen- longitudinal study based in the U.S. The kids she is
der, the writer Robin Marantz tracking appear to be doing well—they don’t seem
Henig recounts the story of a all that diferent, in terms of their mental health and
mother who let her 4-year-old, general happiness, from a control group of cisgender
assigned male at birth, choose kids (that is, kids who identify with the sex they were
a girl’s name, start using female pronouns, and attend assigned at birth).
preschool as a girl. “Almost instantly the gloom lifted,” At the prestigious Center of Expertise on Gender
Henig writes. Dysphoria, at Vrije Universiteit University Medical
Accounts of successful transitions can help fami- Center, in Amsterdam—often referred to simply
lies envision a happy outcome for a sufering child. as “the Dutch clinic”—an older cohort of kids who
And some young people clearly experience some- went through the puberty-blockers-and-cross-sex-
thing like what these caterpillar-to-butterly narra- hormones protocol was also found to be doing well:
tives depict. They have persistent, intense gender “Gender dysphoria had resolved,” according to a
dysphoria from a very young age, and transitioning study of the group published in 2014 in Pediatrics.
alleviates it. “Some kids don’t waver” in their gender “Psychological functioning had steadily improved,
identity, Nate Sharon, a psychiatrist who oversaw a and well-being was comparable to same-age peers.”
gender clinic in New Mexico for two and a half years, These early results, while promising, can tell us
and who is himself trans, told me when we spoke in only so much. Olson’s indings come from a group of
2016. “I’m seeing an 11-year-old who at age 2 went trans kids whose parents are relatively wealthy and
up to his mom and said, ‘When am I going to start are active in trans-support communities; they volun-
growing my penis? Where’s my penis?’ At 2.” teered their children for the study. There are limits to
But these stories tend to elide the complexities how much we can extrapolate from the Dutch study
of being a TGNC young person, or the parent of one. as well: That group went through a comprehensive
Some families will ind a series of forking paths, and diagnostic process prior to transitioning, which
won’t always know which direction is best. Like included continuous access to mental-health care at

92 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
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a top-tier gender clinic—a process unfortunately not much support so-called airming care, which entails
available to every young person who transitions. accepting and exploring a child’s statements about
Among the issues yet to be addressed by long- their gender identity in a compassionate manner. But
term studies are the efects of medications on young they worry that, in an otherwise laudable efort to get
people. As Thomas Steensma, a psychologist and TGNC young people the care they need, some mem-
researcher at the Dutch clinic and a co-author of bers of their ield are ignoring the complexity, and
that study, explained to me, data about the potential luidity, of gender-identity development in young
risks of putting young people on puberty blockers people. These colleagues are approving teenagers
are scarce. He would like to see further research into for hormone therapy, or even top surgery, without
the possible efects of blockers on bone and brain fully examining their mental health or the social and
development. (The potential long-term risks of cross- family inluences that could be shaping their nascent
sex hormones aren’t well known, but are likely mod- sense of their gender identity.
est, according to Joshua Safer, one of the authors of That’s too narrow a deinition of airming care, in
the Endocrine Society’s “Clinical Practice Guideline” the view of many leading clinicians. “Airming care
for treatment of gender dysphoria.) does not privilege any one outcome when it comes to
Meanwhile, fundamental questions about gen- gender identity, but instead aims to allow exploration
der dysphoria remain unanswered. Researchers still of gender without judgment and with a clear under-
don’t know what causes it—gender identity is gen- standing of the risks, beneits, and alternatives to any
erally viewed as a complicated weave of biological, choice along the way,” Aron Janssen, the clinical direc-
psychological, and sociocultural factors. In some tor of the Gender and Sexuality Service at Hassenfeld
cases, gender dysphoria may interact with mental- Children’s Hospital, in New York, told me. “Many peo-
health conditions such as depression and anxiety, but ple misinterpret airming care as proceeding to social
there’s little agreement about how or why. Trauma, and medical transition in all cases without delay, but
particularly sexual trauma, can contribute to or the reality is much more complex.”
exacerbate dysphoria in some patients, but again, no To make sense of this complex reality—and
one yet knows exactly why. ensure the best outcome for all gender-exploring
To reiterate: For many of the young people in the kids—parents need accurate, nuanced information
early studies, transitioning— socially for children, about what gender dysphoria is and about the many
physically for adolescents and young adults—appears blank spots in our current knowledge. They don’t
to have greatly alleviated their dysphoria. But it’s not always get it.
the answer for everyone. Some kids are dysphoric
from a very young age, but in time become com- OR GENDER-DYSPHORIC PEOPLE, physi-
fortable with their body. Some develop dysphoria
around the same time they enter puberty, but their
F cal transition can be life enhancing, even
lifesaving. While representative long-term
sufering is temporary. Others end up identifying as data on the well-being of trans adults have yet to
nonbinary—that is, neither male nor female. emerge, the evidence that does exist—as well as the
Ignoring the diversity of these experiences and sheer heft of personal accounts from trans people
focusing only on those who were efectively “born and from the clinicians who help them transition—is
in the wrong body” could cause harm. That is the overwhelming. For many if not most unwaveringly
argument of a small but vocal group of men and gender- dysphoric people, hormones work. Surgery
women who have transitioned, only to return to their works. That’s relected in studies that consistently
assigned sex. Many of these so-called detransitioners show low regret rates for the least-reversible physi-
argue that their dysphoria was caused not by a deep- cal procedures to address gender dysphoria. One
seated mismatch between their gender identity and 2012 review of past studies, for example, found that
their body but rather by mental-health problems, sex-reassignment surgery “is an efective treatment
trauma, societal misogyny, or some combination of for [gender dysphoria] and the only treatment that
these and other factors. They say they were nudged has been evaluated empirically with large clinical
toward the physical interventions of hormones or sur- case series.” A study on “bottom surgery,” or surgery
gery by peer pressure or by clinicians who overlooked designed to construct a penis or vagina, found that
other potential explanations for their distress. from 1972 to 2015, “only 0.6 percent of transwomen
Some of these interventions are irreversible. Peo- and 0.3 percent of transmen who underwent [these
ple respond diferently to cross-sex hormones, but procedures] were identiied as experiencing regret.”
changes in vocal pitch, body hair, and other physical Those of us who have never sufered from gender
characteristics, such as the development of breast tis- dysphoria can have a hard time appreciating what’s
sue, can become permanent. Kids who go on puberty at stake. Rebecca Kling, an educator at the National
blockers and then on cross-sex hormones may not Center for Transgender Equality, in Washington, D.C.,
be able to have biological children. Surgical inter- told me that before she transitioned she felt as if she
ventions can sometimes be reversed with further were constantly carrying around a backpack full of
surgeries, but often with disappointing results. rocks. “That is going to make everything in my life
The concerns of the detransitioners are echoed by harder, and in many cases is going to make things
a number of clinicians who work in this ield, most of impossible,” she said. “Of course being able to remove
whom are psychologists and psychiatrists. They very that heavy burden has added comfort and stability in

94 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
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my sense of myself and my body.” Other
trans people have ofered similar descrip-
tions of gender dysphoria—a weight, a
buzzing, an unavoidable source of rumi-
nation and worry. Hormones and surgery
grant transgender people profound relief.
Historically, they have been denied
access to that relief. Christine Jorgensen,
the first American to become widely
known for transitioning through hor-
mones and surgery, in the 1950s, had to go
to Denmark for her care. The trans histo-
rian Genny Beemyn notes that Jorgensen’s
doctor “received more than 1,100 letters
from transsexual people, many of whom
sought to be his patients,” in the months
after Jorgensen was treated. As a result
of the requests, “the Danish government
banned such procedures for non-citizens.
In the United States, many physicians sim-
ply dismissed the rapidly growing number
of individuals seeking gender-affirming
surgeries as being mentally ill.”
Today, the situation in the U.S. has
Max Robinson improved, but the lack of access to tran-
went on cross-sex sition services continues to be a problem.
hormones when Whether trans people in this country can
she was 16 and
access treatments such as hormones and
had a double
surgery depends on a variety of factors,
mastectomy
when she was 17.
ranging from where they live to what
Now 22, she has their health insurance will cover (if they
detransitioned have any) to their ability to navigate piles
and identifies of paperwork. Erica Anderson, a trans
as a woman. woman and clinical psychologist who
works at the Child and Adolescent Gen-
der Center, at UC San Francisco’s Beniof
Children’s Hospital, had no luck when
she tried to get hormones from an endocrinologist in “informed consent” protocols, built on the philoso-
Philadelphia just a decade ago. “Even I, with my edu- phy that trans adults, once informed of the potential
cation and resources, was denied care and access,” beneits and risks of medical procedures, have a right
she told me. “The endocrinologist simply said, ‘I to make their own decisions about their body and
don’t do that.’ I ofered to provide her the guidelines shouldn’t have their need for services questioned by
from her own Endocrine Society,” Anderson said. mental-health and medical professionals.
“She refused and wouldn’t even look me in the eye. This shift is seen by many trans people and advo-
No referral or ofer to help. She sent me away with cates as an important course correction after decades
nothing, feeling like I was an undesirable.” of gatekeeping—aloof professionals telling trans peo-
Many trans people have stories like Anderson’s. ple they couldn’t get hormones or surgery, because
For this reason, among others, trans communities they weren’t really trans, or hadn’t been living as a
can be skeptical of those who focus on negative tran- trans person long enough, or were too mentally ill.
sition outcomes. They have long dealt with “profes-
sionals who seem uncomfortable giving trans people OR GENDER- QUESTIONING CHILDREN
the go-ahead to transition at all,” Zinnia Jones, a
trans woman who runs the website GenderAnalysis,
F and teens, the landscape is diferent. A minor’s
legal guardian almost always has to provide
told me in an email. They have also faced “unneces- consent prior to a medical procedure, whether it’s
sarily protracted timelines for accessing care, a lack of a tonsillectomy or top surgery. WPATH and other
understanding or excess skepticism of our identities organizations that provide guidance for transitioning
from clinicians, and so on.” young people call for thorough assessments of patients
Groups like WPATH, the primary organization before they start taking blockers or hormones.
for psychologists, psychiatrists, endocrinologists, This caution comes from the concerns inherent
surgeons, and others who work with TGNC clients, in working with young people. Adolescents change
have attempted to reverse this neglect in recent years. signiicantly and rapidly; they may view themselves
A growing number of adult gender clinics follow and their place in the world differently at 15 than

96 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C PHOTOGRAPH BY CHLOE AFTEL


they did at 12. “You’ve got the onset of acknowledging that feelings of gender dysphoria can
puberty right around the age where they be exacerbated by mental-health diiculties, trauma,
develop the concept of abstract thinking,” or a combination of the two?
said Nate Sharon, the New Mexico psychi- Clinicians are still wrestling with how to define
atrist. “So they may start to conceptualize airming care, and how to balance airmation and
gender concepts in a much richer, broader caution when treating adolescents. “I don’t want to
manner than previously—and then maybe be a gatekeeper,” Dianne Berg, a co-director of the
puberty blockers or cross-sex hormones National Center for Gender Spectrum Health, at the
aren’t for them.” That was true for Claire: University of Minnesota, told me. “But I also worry that
A shift in her understanding of the nature in opening the gates, we’re going to have more adoles-
of gender led her to realize that transition- cents that don’t engage in the relective work needed
ing was not the answer for her. in order to make sound decisions, and there might
For younger children, gender identity end up being more people when they are older that
is an even trickier concept. In one experi- are like, Oh, hmm—now I am not sure about this.”
ment, for example, many 3-to-5-year-olds
thought that if a boy put on a dress, he HEN MAX ROBINS ON was 17, getting a
became a girl. Gender clinicians some-
times encounter young children who
W double mastectomy made perfect sense to
her. In fact, it felt like her only option—like
believe they are, or want to be, another a miraculous, lifesaving proce-
gender because of their dress or play dure. Though she had a wom-
preferences—I like rough-and-tumble play, an’s body, she was really a man.
so I must be a boy—but who don’t meet the Surgery would inally ofer her
criteria for gender dysphoria. a chance to be herself.
In the past, therapists and doctors I met Max, now 22, in an Affirming care
interpreted the fluidity of gender iden- airy café in the quiet southern- is far more
tity among children as license to put Oregon town where she lives.
gender-bending kids into the “right” box She was wearing a T-shirt
humane
by encouraging—or forcing—them to with a flannel button-down than older
play with the “right” toys and dress in over it. On her head, a gray philosophies.
the “right” clothes. Until about ive years winter cap; at her feet, a
ago, according to one clinician’s estimate, shaggy white service dog. By But it conflicts,
social transition was often frowned upon. the time we met, we’d spoken at least a little,
For decades, trans-ness was sometimes
tolerated in adults as a last-ditch out-
on the phone and exchanged a
number of emails, and she had
with what we
come, but in young people it was more told me her story—one that know about
often seen as something to be drummed suggests the complexity of gender-identity
out rather than explored or accepted. So- gender-identity development.
called reparative therapy has harmed and humiliated Max recalled that as early
fluidity in
trans and gender-nonconforming children. In her as age 5, she didn’t enjoy being young people.
book Gender Born, Gender Made, Diane Ehrensaft, the treated like a girl. “I ques-
director of mental health at UC San Francisco’s Child tioned my teachers about why
and Adolescent Gender Center, writes that victims of I had to make an angel instead
these practices “become listless or agitated, long for of a Santa for a Christmas craft,
their taken-away favorite toys and clothes, and even or why the girls’ bathroom pass had ribbons instead
literally go into hiding in closets to continue play- of soccer balls, when I played soccer and knew lots
ing with the verboten toys or wearing the forbidden of other girls in our class who loved soccer,” she said.
clothes.” Such therapy is now viewed as unethical. She grew up a happy tomboy—until puberty.
These days, mainstream youth-gender clinicians “People expect you to grow out of it” at that age, she
practice airming care instead. They listen to their explained, “and people start getting uncomfortable
young patients, take their statements about their gen- when you don’t.” Worse, “the way people treated me
der seriously, and often help facilitate social and physi- started getting increasingly sexualized.” She remem-
cal transition. Airming care has quickly become a bered one boy who, when she was 12, kept asking her
professional imperative: Don’t question who your cli- to pick up his pencil so he could look down her shirt.
ents are—let them tell you who they are, and accept “I started dissociating from my body a lot more
their identity in a nurturing, encouraging manner. when I started going through puberty,” Max said. Her
The airming approach is far more humane than discomfort grew more internalized—less a frustration
older ones, but it conlicts, at least a little, with what with how the world treated women and more a sense
we know about gender-identity fluidity in young that the problem lay in her own body. She came to
people. What does it mean to be affirming while believe that being a woman was “something I had to
acknowledging that kids and teenagers can have control and ix.” She had tried various ways of making
an understanding of gender that changes over a her discomfort abate—in seventh grade, she vacillated
short span? What does it mean to be airming while between “dressing like a 12-year-old boy” and wearing

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 97
revealing, low-cut outits, attempts to defy and accede be performed only on adults who have been living
to the demands the world was making of her body. But in their gender role for at least one year.) Max went
nothing could banish her feeling that womanhood into the surgery optimistic. “I was convinced it would
wasn’t for her. She had more bad experiences with solve a lot of my problems,” she said, “and I hadn’t
men, too: When she was 13, she had sex with an older accurately named a lot of those problems yet.”
man she was seeing; at the time, it felt consensual, but Max was initially happy with the results of her
she has since realized that a 13-year-old can’t consent physical transformation. Before surgery, she wasn’t
to sex with an 18-year-old. At 14, she witnessed a able to fully pass as male. After surgery, between her
friend get molested by an adult man at a church slum- newly masculinized chest and the facial hair she was
ber party. Around this time, Max was diagnosed with able to grow thanks to the hormones, she felt like she
depression and generalized anxiety disorder. had left behind the sex she had been assigned at birth.
In ninth grade, Max irst encountered the concept “It felt like an accomplishment to be seen the way I
of being transgender when she watched an episode wanted to be seen,” she told me.
of The Tyra Banks Show in which Buck Angel, a trans But that feeling didn’t last. After her surgery, Max
porn star, talked about his transition. It opened up a moved from her native California to Portland and
new world of online gender-identity exploration. She threw herself into the trans scene there. It wasn’t a
gradually decided that she needed to transition. happy home. The clarity of identity she was seeking—
Max’s parents were skeptical at irst but eventually and that she’d felt, temporarily, after starting hor-
came around, signing her up for sessions with a thera- mones and undergoing surgery—never fully set in.
pist who specialized in gender-identity issues. She Her discomfort didn’t go away.
recalled that the specialist was very open to putting Today, Max identiies as a woman. She believes
her on a track toward transition, though he suggested that she misinterpreted her sexual orientation, as
that her discomfort could have other sources as well. well as the efects of the misogyny and trauma she
Max, however, was certain had experienced as a young person, as being about
that transitioning was the gender identity. Because of the hormone therapy,
answer. She told me that she she still has facial hair and is frequently mistaken for
“refused to talk about anything male as a result, but she has learned to live with this:
“I’m a real-live other than transition.” “My sense of self isn’t entirely dependent on how
When Max was 16, her other people see me.”
22-year-old therapist wrote her a referral
woman with a to see an endocrinologist who AX IS ONE of what appears to be a growing
scarred chest and
a broken voice
could help her begin the pro-
cess of physical transition by
M number of people who believe they were
failed by the therapists and physicians they
prescribing male hormones. went to for help with their gender dysphoria. While
and a 5 o’clock The endocrinologist was their individual stories difer, they tend to touch on
shadow because skeptical, Max said. “I think similar themes. Most began transitioning during ado-
what she was seeing was a lescence or early adulthood. Many were on hormones
I couldn’t face lesbian teenager,” not a trans for extended periods of time, causing permanent
the idea of one. At the time, though, Max changes to their voice, appearance, or both. Some,
growing up to be interpreted the doctor’s reluc-
tance as her “being ignor-
like Max, also had surgery.
Many detransitioners feel that during the process
a woman,” said ant, as her trying to hurt me.” leading up to their transition, well-meaning clini-
Cari Stella, a Armed with the referral from cians left unexplored their overlapping mental-health
her therapist, Max got the troubles or past traumas. Though Max’s therapist
detransitioner. endocrinologist to prescribe had tried to work on other issues with her, Max now
the treatment she sought. believes she was encouraged to rush into physical
Max started taking tes- transition by clinicians operating within a framework
tosterone. She experienced that saw it as the only way someone like her could
some side efects—hot lashes, memory issues—but experience relief. Despite the fact that she was a
the hormones also provided real relief. Her plan all minor for much of the process, she says, her doctors
along had been to get top surgery, too, and the ini- more or less did as she told them.
tially promising efects of the hormones helped per- Over the past couple of years, the detransitioner
suade her to continue on this path. When she was 17, movement has become more visible. Last fall, Max
Max, who was still dealing with major mental-health told her story to The Economist’s magazine of cul-
issues, was scheduled for surgery. ture and ideas, 1843. Detransitioners who previously
Because Max had parental approval, the surgeon blogged pseudonymously, largely on Tumblr, have
she saw agreed to operate on her despite the fact begun writing under their real names, as well as
that she was still a minor. (It’s become more com- speaking on camera in YouTube videos.
mon for surgeons to perform top surgeries on teen- Cari Stella is the author of a blog called Guide on
agers as young as 16 if they have parental approval. Raging Stars. Stella, now 24, socially transitioned
The medical norms are more conservative when it at 15, started hormones at 17, got a double mastec-
comes to bottom surgeries; WPATH says they should tomy at 20, and detransitioned at 22. “I’m a real-live

98 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
22-year-old woman with a scarred chest and a broken make it all the way to medical transition, then it’s Carey Callahan
voice and a 5 o’clock shadow because I couldn’t face probably going to work out well for you.” serves as something
the idea of growing up to be a woman,” she said in a Carey said she met people who appeared to be of an older sister to
a group of women
video posted in August 2016. “I was not a very emo- grappling with severe trauma and mental illness,
who, like her, have
tionally stable teenager,” she told me when we spoke. but were ixated on their next transition milestone,
detransitioned.
Transitioning ofered a “level of control over how I convinced that was the moment when they would
was being perceived.” get better. “I knew a lot of people committed to that
Carey Callahan is a 36-year-old woman living in narrative who didn’t seem to be doing well,” she
Ohio who detransitioned after identifying as trans recalled. Carey’s time at the clinic made her real-
for four years and spending nine months on male ize that testosterone hadn’t made her feel better in a
hormones. She previously blogged under the pseudo- sustained way either. She detransitioned, moved to
nym Maria Catt, but “came out” in a YouTube video in Ohio, and is now calling for a more careful approach
July 2016. She now serves as something of an older sister to treating gender dysphoria than what many detran-
to a network of female, mostly younger detransitioners, sitioners say they experienced themselves.
about 70 of whom she has met in person; she told me In part, that would mean clinicians adhering to
she has corresponded online with an additional 300. guidelines like WPATH’s Standards of Care, which
(The detransitioners who have spoken out thus far are nonbinding. “When I look at what the SOC
are mostly people who were assigned female at birth. describes, and then I look at my own experience and
Traditionally, most new arrivals at youth gender clinics my friends’ experiences of pursuing hormones and
were assigned male; today, many clinics are reporting surgery, there’s hardly any overlap between the direc-
that new patients are mostly assigned female. There is tives of the SOC and the reality of care patients get,”
no consensus explanation for the change.) Carey told me. “We didn’t discuss all the implications
I met Carey in Columbus in March. She told me of medical intervention—psychological, social, physi-
that her decision to detransition grew out of her cal, sexual, occupational, inancial, and legal—which
experience working at a trans clinic in San Francisco the SOC directs the mental-health professional to
in 2014 and 2015. “People had said often to me that discuss. What the SOC describes and the care people
when you transition, your gender dysphoria gets get before getting cleared for hormones and surgery
worse before it gets better,” she told me. “But I saw are miles apart.”
and knew so many people who were cutting them- Detransitioners, understandably, elicit suspicion
selves, starving themselves, never leaving their apart- from the trans community. Imagine being a trans
ments. That made me doubt the narrative that if you person who endured a bruising ight to prove to your

P H OTO G R A P H S BY M AT T E I C H T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 99
psychiatrist and endocrinologist that you are trans, in HEN IT C OME S to helping TGNC young
order to gain access to hormones that greatly improve
your quality of life, that relieve sufering. You might
W people gain access to physical inter-
ventions, few American clinicians possess
view with skepticism—at the very least—a group the bona ides of the psychologist Laura Edwards-
calling for more gatekeeping. Conservative media Leeper. A decade ago, when she was working at Bos-
outlets, for their part, often seize on detransition ton Children’s Hospital, she visited the Dutch clinic
narratives to push the idea that being trans is some to learn the puberty-blocking protocol pioneered
sort of liberal invention. “How Carey Was Set Free there. She helped bring that protocol back to Boston,
From Transgenderism” was the conservative website where she worked with the irst-ever group of Ameri-
LifeSiteNews’ disingenuous take on Carey’s story. can kids to go through that process.
No one knows how common detransitioning is. Today, Edwards-Leeper oversees a collaboration
A frequently cited statistic—that only 2.2 percent between Paciic University and Oregon’s Transgender
of people who physically transition later regret it— Clinic, within the nonproit Legacy Health system. At
doesn’t paint a complete picture. It comes from a Paciic, she is training clinical-psychology doctoral stu-
study, conducted in Sweden, that examined only dents to conduct “readiness assessments” for young
those people who had undergone sex-reassignment people seeking physical-transition services.
surgery and legally changed their gender, then In February, I visited one of her classes at Paciic,
applied to change their gender back—a standard just outside Portland. For an hour, she let me pepper
that, Carey pointed out, would have excluded her her students with questions about their experiences
Laura Edwards- and most of the detransitioners she knows. as clinicians-in-training in what is essentially a brand-
Leeper, a clinician at It stands to reason that as any medical procedure new ield. When the subject of detransitioners came
Pacific University
becomes more readily available, a higher number of up, Edwards-Leeper chimed in. “I’ve been predict-
and Oregon’s
people will regret having it. Why focus on detran- ing this for, I don’t know, the last ive or more years,”
Transgender Clinic.
She brought the
sitioners, when no one even knows whether their she said. “I anticipate there being more and more
puberty-blocking experiences are all that common? One answer is that and more, because there are so many youth who are
transition protocol clinicians who have logged thousands of hours work- now getting services with very limited mental-health
pioneered by the ing with transgender and gender-nonconforming assessment and sometimes no mental-health assess-
Dutch to the U.S. young people are raising the same concerns. ment. It’s inevitable, I think.”

100 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
Edwards-Leeper believes that comprehensive supporting these trans youth to get the services they
assessments are crucial to achieving good outcomes need,” Edwards-Leeper recalled. “People thought this
for TGNC young people, especially those seeking was just crazy, and thought the four-hour evaluations
physical interventions, in part because some kids I was doing were, too—how could that possibly be
who think they are trans at one point in time will not enough to decide whether to go forward with the medi-
feel that way later on. This is a controversial subject cal intervention? That was 2007, and now the ques-
in some corners of the trans community. A small tions I get are ‘Why do you make people go through
group of studies has been interpreted as showing any kind of evaluation?’ And ‘Why does mental health
that the majority of children who experience gender need to be involved in this?’ And ‘We should just listen
dysphoria eventually stop experiencing it and come to what the kids say and listen to what the adolescents
to identify as cisgender adults. (In these studies, chil- say and basically just treat them like adults.’ ”
dren who sufer intense dysphoria over an extended The six trainees on Edwards-Leeper’s Trans-
period of time, especially into adolescence, are more gender Youth Assessment Team spoke about the
likely to identify as trans in the long run.) myriad ways mental-health issues and social and
This so-called desistance research has been cultural inluences can complicate a child’s concep-
attacked on various methodological grounds. The tion of gender. “I would say ‘airming’ isn’t always
most-credible critiques center on the claim that some doing exactly what the kid says they want in the
kids who were merely gender nonconforming—that is, moment,” one said. Another
they preferred stereotypically cross-sex activities added: “Our role as clinicians
or styles of dress—but not dysphoric may have been isn’t to conirm or disconirm
counted as desisters because the studies relied on out- someone’s gender identity—
dated diagnostic criteria, artiicially pushing the per- it’s to help them explore it
centage upward. (The terms detransition and desist with a little bit more nuance.”
“I think the
are used in diferent ways by diferent people. In this I asked the students whether pendulum has
article, I am drawing this distinction: Detransitioners they had come across the swung so far
are people who undergo social or physical transitions idea that conducting in-depth
and later reverse them; desisters are people who stop assessments is insulting or
that now we’re
experiencing gender dysphoria without having fully stigmatizing. They all nodded. maybe not
transitioned socially or physically.) “Well, they know what reputa- looking as
The desistance rate for accurately diagnosed tion I have,” Edwards-Leeper
dysphoric kids is probably lower than some of the said with a laugh. “I told them critically at the
contested studies suggest; a small number of merely about things almost being issues as we
gender-nonconforming kids may indeed have been
wrongly swept into even some of the most recent stud-
thrown at me at conferences.”
Those conference troubles
should be,” says
ies, which didn’t use the most up-to-date criteria, from signaled to Edwards-Leeper the psychologist
the DSM-5. And there remains a paucity of big, rigor- that her field had shifted in Dianne Berg.
ous studies that might deliver a more reliable igure. ways she found discomfit-
Within a subset of trans advocacy, however, desis- ing. At one conference a few
tance isn’t viewed as a phenomenon we’ve yet to fully years ago, she recalled, a
understand and quantify but rather as a myth to be dis- co-panelist who was a well-
pelled. Those who raise the subject of desistance are respected clinician in her field said that Edwards-
often believed to have nefarious motives—the liberal Leeper’s comprehensive assessments required
outlet ThinkProgress, for example, referred to desis- kids to “jump through more iery hoops” and were
tance research as “the pernicious junk science stalking “retraumatizing.” This prompted a standing ovation
trans kids,” and a subgenre of articles and blog posts from the audience, mostly families of TGNC young
attempts to debunk “the desistance myth.” But the people. During another panel discussion, at the same
evidence that desistance occurs is overwhelming. The conference with the same clinician, but this time
American Psychological Association, the Substance geared toward fellow clinicians, the same thing hap-
Abuse and Mental Health Services Administration, pened: more claims that assessments were traumatiz-
the Endocrine Society, and WPATH all recognize that ing, more raucous applause.
desistance occurs. I didn’t speak with a single clinician Edwards-Leeper isn’t alone in worrying that the
who believes otherwise. “I’ve seen it clinically hap- ield is straying from its own established best prac-
pen,” Nate Sharon said. “It’s not a myth.” tices. “Under the motivation to be supportive and to
Despite this general agreement, Edwards-Leeper be airming and to be nonstigmatizing, I think the
worries that treatment practices are trending toward pendulum has swung so far that now we’re maybe
an interpretation of airming care that entails nodding not looking as critically at the issues as we should be,”
along with children and adolescents who say they want the National Center for Gender Spectrum Health’s
physical interventions rather than evaluating whether Dianne Berg told me. Erica Anderson, the UCSF
they are likely to beneit from them. clinician, expressed similar concerns: “Some of the
A decade ago, the opposite was true. “I was con- stories we’ve heard about detransitioning, I fear, are
stantly having to justify why we should be ofering related to people who hastily embarked on medi-
puberty-blocking medication, why we should be cal interventions and decided that they weren’t for

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 101
them, and didn’t thoroughly vet their decision either OMPETENT CLINICIANS do occasionally
by themselves or with professional people who could
help them.”
C challenge their clients’ conception of their
gender identity in order to ensure that they
Even some of the clinicians who have emphasized are approaching the subject in a suiciently sophis-
the need to be deferential to young people acknowl- ticated manner. They want to make sure that a given
edge the complexities at play here. A psychologist patient has gender dysphoria, as defined in the
with decades of experience working with TGNC DSM-5, and that their current gender identity is a con-
young people, Diane Ehrensaft is perhaps the most sistent part of who they are. If a teenager inds that
frequently quoted youth-gender clinician in the his dysphoria lessens signiicantly when he presents
country. She is tireless in her advocacy for trans kids. himself in a more feminine way or once his overlap-
“It’s the children who are now leading us,” she told ping mental-health problems have been treated, he
The Washington Post recently. She sees this as a posi- may develop a diferent view on the necessity of hor-
tive development: “If you listen to the children, you mones or surgery.
will discover their gender,” she wrote in one article. This is not to say that talk therapy can cure seri-
“It is not for us to tell, but for them to say.” ous gender dysphoria. Edwards-Leeper worked to
But when I spoke with Ehrensaft at her home in introduce the Dutch protocol of blockers and hor-
Oakland, she described many situations involving mones in the United States precisely because she
physical interventions in which her work was far believes that it alleviates dysphoria in cases where
more complicated than simply airming a client’s there would otherwise be prolonged sufering. But
self- diagnosis. “This is what I tell kids all the time, clinicians like her are also careful, given the upheav-
particularly teenagers,” she said. “Often they’re als of adolescence and the luid conception of gen-
pushing for fast. I say, ‘Look, I’m old, you’re young. der identity among young people, not to assume that
I go slow, you go fast. We’re going to have to work because a young person has gender dysphoria, they
that out.’ ” Sometimes, she said, she suspects that a should automatically go on hormones.
kid who wants hormones right now is simply recit- Edwards-Leeper is hoping to promote a concept
ing something he found on the internet. “It just feels of airming care that takes into account the develop-
wooden, is the only thing I can say,” she told me. mental nuances that so often come up in her clinical
At the end of our interview, Ehrensaft showed me work. In this efort, she is joined by Scott Leibowitz, a
Scott Padberg, a
a slide from a talk she was preparing about what it psychiatrist who treats children and adolescents. He
16-year-old patient
of Laura Edwards-
means to be an airming clinician: “REALITY: WE is the medical director of behavioral health for the
Leeper who went on ARE NEITHER RUBBER STAMPERS NOR PUSH- THRIVE program at Nationwide Children’s Hospital,
cross-sex hormones ERS; WE ARE FACILITATORS.” This isn’t so far of in Columbus. Leibowitz has a long history of work-
and recently had a from the deinition of the clinician’s role expressed by ing with and supporting TGNC youth—he served as
double mastectomy Edwards-Leeper’s students. an expert witness for the Department of Justice in

102 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
2016, when President Barack Obama’s administration diferent since I felt conscious of the fact that I was Orion Foss worked
challenged state-level “bathroom bills” that sought to alive,” he said. For part of his childhood, that was ine with the clinicians
prevent trans people from using the public bathroom with everyone around him. He was granted all the at Ohio’s THRIVE
associated with their gender identity. Edwards-Leeper freedom he needed to express himself in a gender- clinic on his
mental health, his
and Leibowitz met at Boston Children’s, where Leibo- nonconforming manner, from getting short haircuts
mother’s concerns,
witz did his psychiatry fellowship, and the two have to playing with stereotypically male toys like dino-
and, eventually,
been close friends and collaborators ever since. saurs and Transformers. But the freedom didn’t last. his transition.
While it’s understandable, for historical reasons, When he was 7, his mom married a “super Christian
why some people associate comprehensive psycho- guy” who tried to impose femininity on him. “It’s
logical assessments with denial of access to care, that really degrading,” Scott said, to be forced to wear a
isn’t how Leibowitz and Edwards-Leeper view their dress when you’re a trans boy. (Scott’s mom divorced
approach. Yes, they want to discern whether a patient her devout husband two years later, and Nancy
actually has gender dysphoria. But comprehensive eventually took custody of Scott.)
assessments and ongoing mental-health work are Puberty brought bigger problems. Scott started
also means of ensuring that transitioning—which developing breasts and got his period. “Everything
can be a physically and emotionally taxing process for just sucked, basically,” he said. “I was pretty miserable
adolescents even under the best of circumstances— with it.” In 2015, when Scott was 13, Nancy took him
goes smoothly. to an assessment appointment with Edwards-Leeper.
Scott Padberg, one of Edwards-Leeper’s patients, “She asked me about how I felt when I was younger—
is a good example of how her comprehensive- was I comfortable with my body? What did I tend to
assessment process looks for teenagers with a rela- like or be interested in?,” Scott recalled. He said that
tively straightforward history of persistent gender getting on testosterone took what felt like a long time.
dysphoria and an absence of other factors that might (He was on puberty blockers for about a year.) But he
complicate their diagnosis and transition path. I met said he understood that Edwards-Leeper was making
Scott and his grandmother and legal guardian, Nancy, certain he had considered a range of questions—from
at a wrap place in Welches, Oregon, not far from where how he would feel about possibly not being able to
they live. It was a mild February day, so we sat in one of have biological kids to whether he was comfortable
the pine booths outside the restaurant. Mount Hood’s with certain hormonal efects, such as a deeper voice.
massive snowcapped peak loomed nearby. Scott told Edwards-Leeper that he was pretty certain
Scott, a 16-year-old who radiates calm, explained about what he wanted.
that despite having been assigned female at birth, Scott told me that overall, being on testosterone
he simply never felt like a girl. “I guess I kinda felt made him feel better, though also a bit more into

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 103
which had led to self-harm issues, as well
as what may have been an undiagnosed
eating disorder. Orion believed that addi-
tional weight went straight to his hips
and chest, accentuating his feminine
features. At one point, he dipped down
to 70 pounds.
A year or so after he realized he was
trans, he told his mother, an ob-gyn,
who took him to the THRIVE program at
Nationwide, which had recently opened.
(Leibowitz didn’t work there yet.) Orion
met with two clinicians for an eight-hour
assessment. He told me he was “defi-
nitely intimidated,” but if “you want to
do something permanent to your body,
you have to be absolutely positive that
there’s no other way of doing it.”
At the time, Orion was initially upset
that, because he was underage, THRIVE
wouldn’t put him on hormones without
the consent of both parents (his father had
signed of, but his mother had not). He
started sobbing when he found out. But
the THRIVE team made clear that it was
going to help him get where he wanted to
be. In the meantime, a THRIVE therapist,
Lourdes Hill, would work with Orion to
address his anxiety and depression.
Scott Leibowitz, “adrenaline-junkie stuff ” than before. (There had Looking back, Orion sees the value of this pro-
a psychiatrist who been a recent incident involving Scott taking Nancy’s cess. “If I had been put on hormone therapy when I
treats children and car for a spin despite not yet having his learner’s per- didn’t have my identity settled, and who I was settled,
adolescents in
mit.) When I asked him about top surgery, which he and my emotions settled, it would have been crazy.
Columbus, Ohio, is a
was hoping to have early in the spring, he got about ’Cause when I did start hormone therapy, hormones
proponent of
comprehensive
as animated as I saw him during our lunch. “Oh, it’s shoot your mood all around, and it’s not exactly
assessments for going to be so freeing,” he said. “I can change in the safe to just shoot hormones into someone that’s not
young people seeking locker room!” In April I checked in with Nancy, and stable.” He ended up seeing Hill for weekly appoint-
to transition. she said in an email that the surgery had gone well: ments, talking about not only his gender-identity and
“He is SO happy not to have to wear a binder!” mental-health issues, but a host of other subjects as
Scott’s assessment process centered mostly on well. “She weeded through every possible issue with
the basic readiness questions Edwards-Leeper and me that she could get to,” he said. “I’m glad she made
Leibowitz are convinced should be asked of any me wait. And I’m glad the structure was there so I
young person considering hormones. But his was a couldn’t just throw myself into something that prob-
relatively clear-cut case: He’d had unwavering gen- ably would have made me worse of.”
der dysphoria since early childhood, a lack of serious Eventually, his mother, who was “very hesitant,”
mental-health concerns, and a generally supportive and was refusing to sign the paperwork for him to start
family. For other gender-dysphoric young people, hormones, came around. The THRIVE team helped
mental-health problems and family dynamics can her come to grips with the fact that the child she had
complicate the transition process, though they are by always known as her daughter was going to become
no means, on their own, an indication that someone her son. “Lourdes was the driving force in that,” Orion
shouldn’t transition. told me in a follow-up email. “Spent a lot of time with
I met Orion Foss at a vegetarian café in the Den- me and my mother in therapy.”
nison Place neighborhood of Columbus. Orion is an When he was inally able to begin the hormone
expressive 18-year-old with big eyes who is where treatments, Orion said, he “immediately felt this
Scott Padberg may be in a couple of years. Orion’s weight of my shoulders.” His dosage was gradually
gender trajectory was a bit different, though. As increased and then, in May 2017, he got a double
a teenager, he identiied as a lesbian and became mastectomy. Orion’s transition has clearly had a
involved in the local LGBTQ scene. He says that in profoundly beneicial efect. It’s changed the way
2014, when he was 14 years old and trans narratives he carries himself in the world. Before, “I would sit
were starting to show up more frequently on social like this”—he slouched over—“and hide every pos-
media, he realized he was trans. He was also sufer- sible female thing about me.” Now, he said, he can
ing from severe depression and anxiety at the time, sit up straight. He feels like himself.

104 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
OME PARENT S STRUGGLE with the chal- access to hormones is the difference between
S lenges of raising a TGNC child, and they can
make gender clinicians’ already compli-
suicide and survival. Leibowitz noted that a relation-
ship with a caring therapist may itself be an impor-
cated jobs that much more complicated. Many, like tant prophylactic against suicidal ideation for TGNC
Orion Foss’s mother, have trouble accepting the youth: “Often for the irst time having a medical or
idea of their child transitioning. She, at least, came mental-health professional tell them that they are
around. In other cases, parents not only refuse to going to take them seriously and really listen to them
help their child receive treatment but physically and hear their story often helps them feel better than
abuse them or kick them out of the house. (Reliable they’ve ever felt.”
numbers for trans young people speciically are hard The conversations parents are having about
to come by, but LGBTQ youth are 120 percent more gender-dysphoric children online aren’t always so
likely than their straight or cisgender counterparts nuanced, however. In many of these conversations,
to experience a period of homelessness, according parents who say they have questions about the pace of
to a study by Chapin Hall, a research center at the their child’s transition, or whether gender dysphoria is
University of Chicago.) permanent, are told they are playing games with their
But progressive-minded parents can sometimes child’s life. “Would you rather have a live daughter or
be a problem for their kids as well. Several of the a dead son?” is a common response to such questions.
clinicians I spoke with, including Nate Sharon, Laura “This type of narrative takes an already fearful parent
Edwards-Leeper, and Scott Leibowitz, recounted and makes them even more
new patients’ arriving at their clinics, their parents afraid, which is hardly the
having already developed detailed plans for them to type of mind-set one would
transition. “I’ve actually had patients with parents want a parent to be in when
pressuring me to recommend their kids start hor- making a complex lifelong
mones,” Sharon said. decision for their adolescent,”
In some cases,
In these cases, the child might be capably navi- Leibowitz said. a child might
gating a liminal period of gender exploration; it’s the be capably
parents who are having trouble not knowing whether H E N PA R E N T S
their kid is a boy or a girl. As Sharon put it: “Every-
thing’s going great, but Mom’s like, ‘My transgender
W discuss the reasons
they question their
navigating a
liminal period
kid is going to commit suicide as soon as he starts children’s desire to transition, of gender
puberty, and we need to start the hormones now.’ whether in online forums or
And I’m like, ‘Actually, your kid’s just ine right now. in response to a journalist’s exploration;
And we want to leave it open to him, for him to decide questions, many mention it’s the parents
that.’ Don’t put that in stone for this kid, you know?”
Suicide is the dark undercurrent of many discus-
“social contagion.” These
parents are worried that their
who are having
sions among parents of TGNC young people. Sui- kids are influenced by the trouble not
cide and suicidal ideation are tragically common in gender-identity exploration knowing whether
the transgender community. An analysis conducted they’re seeing online and per-
by the American Foundation for Suicide Prevention haps at school or in other social
their kid is
and the Williams Institute, published in 2014, found settings, rather than experi- a boy or a girl.
that 41 percent of trans respondents had attempted encing gender dysphoria.
suicide; 4.6 percent of the overall U.S. population Many trans advocates ind
report having attempted suicide at least once. While the idea of social contagion
the authors note that for methodological reasons silly or even ofensive given the bullying, violence, and
41 percent is likely an overestimate, it still points to a other abuse this population faces. They also point out
scarily high igure, and other research has consistently that some parents simply might not want a trans kid—
shown that trans people have elevated rates of suicidal again, parental skepticism or rejection is a painfully
ideation and suicide relative to cisgender people. common experience for trans young people. Michelle
But the existence of a high suicide rate among Forcier, a pediatrician who specializes in youth-gender
trans people—a population facing high instances of issues in Rhode Island, said the trans adolescents she
homelessness, sexual assault, and discrimination— works with frequently tell her things like No one’s tak-
does not imply that it is common for young people ing me seriously—my parents think this is a phase or a fad.
to become suicidal if they aren’t granted immediate But some anecdotal evidence suggests that
access to puberty blockers or hormones. Parents and social forces can play a role in a young person’s gen-
clinicians do need to make fraught decisions fairly der questioning. “I’ve been seeing this more fre-
quickly in certain situations. When severely dys- quently,” Laura Edwards-Leeper wrote in an email.
phoric kids are approaching puberty, for instance, Her young clients talk openly about peer inluence,
blockers can be a crucial tool to buy time, and some- saying things like Oh, Steve is really trans, but Rachel
times there’s a genuine rush to gain access to them, is just doing it for attention. Scott Padberg did exactly
particularly in light of the waiting lists at many gen- this when we met for lunch: He said there are kids in
der clinics. But the clinicians I interviewed said they his school who claim to be trans but who he believes
rarely encounter situations in which immediate are not. “They all launt it around, like: ‘I’m trans,

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 105
I’m trans, I’m trans,’ ” he said. “They post it on It’s imperative to remember that Delta’s is a kind
social media.” of story that can happen only in a place where trans
I heard a similar story from a quirky 16-year-old people are accepted—and where parents, even skep-
theater kid who was going by the nickname Delta tical ones like Jenny, are open-minded enough to
when we spoke. She lives outside Portland, Oregon, take their kid to a clinician like Edwards-Leeper. In
with her mother and father. A wave of gender-identity vast swaths of the United States, kids coming out as
experimentation hit her social circle in 2013. Suddenly, trans are much more likely to be met with hostility
it seemed, no one was cisgender anymore. Delta, who than with enhanced social status or recognition, and
was 13 and homeschooled, soon announced to her their parents are more likely to lack the willingness—
parents that she was genderqueer, then nonbinary, or the resources—to ind them care. But to deny the
and inally trans. Then she told them she wanted to possibility of a connection between social inluences
go on testosterone. Her parents were skeptical, both and gender-identity exploration among adolescents
because of the social inluence they saw at work and would require ignoring a lot of what we know about
because Delta had anxiety and depression, which the developing teenage brain—which is more suscep-
they felt could be contributing to her distress. But tible to peer inluence, more impulsive, and less adept
when her mother, Jenny, sought out information, she at weighing long-term outcomes and consequences
found herself in online parenting groups where she than fully developed adult brains—as well as indi-
was told that if she dragged her feet about Delta’s vidual stories like Delta’s.
transition, she was poten-
tially endangering her daugh- OT EVERY ONE AGREE S about the impor-
ter. “Any questioning brought
down the hammer on you,”
N tance of comprehensive assessments for
transgender and gender-nonconforming
she told me. youth. Within the small community of clinicians
One clinician Delta’s parents took her to who work with TGNC young people, some have a
said her trans see Edwards-Leeper. The psy- reputation for being skeptical about the value of
clients talk chologist didn’t question her assessments. Johanna Olson-Kennedy, a physician
about being trans or close the who specializes in pediatric and adolescent medi-
openly about door on her eventually start- cine at Children’s Hospital Los Angeles and who is
peer influence, ing hormones. Rather, she the medical director of the Center for Transyouth
saying things asked Delta a host of detailed Health and Development, is one of the most sought-
questions about her life and out voices on these issues, and has signiicant dif-
like Oh, Steve mental health and family. ferences with Edwards-Leeper and Leibowitz. In
is really trans, Edwards-Leeper advised her “Mental Health Disparities Among Transgender
but Rachel is to wait until she was a bit older
to take steps toward a physical
Youth: Rethinking the Role of Professionals,” a 2016
JAMA Pediatrics article, she wrote that “establishing
just doing transition—as Delta recalled, a therapeutic relationship entails honesty and a
it for attention. she said something like “I sense of safety that can be compromised if young
acknowledge that you feel a people believe that what they need and deserve
certain way, but I think we (potentially blockers, hormones, or surgery) can be
should work on other stuf irst, denied them according to the information they pro-
and then if you still feel this way vide to the therapist.”
later on in life, then I will help you with that.” This view is informed by the fact that Olson-
“Other stuff ” mostly meant her problems with Kennedy is not convinced that mental-health assess-
anxiety and depression. Edwards-Leeper told Jenny ments lead to better outcomes. “We don’t actually
and Delta that while Delta met the clinical threshold have data on whether psychological assessments
for gender dysphoria, a deliberate approach made lower regret rates,” she told me. She believes that
the most sense in light of her mental-health issues. therapy can be helpful for many TGNC young people,
“At the time I was not happy that she told me that I but she opposes mandating mental-health assess-
should go and deal with mental stuf irst,” Delta said, ments for all kids seeking to transition. As she put it
“but I’m glad that she said that, because too many when we talked, “I don’t send someone to a therapist
people are so gung ho and just like, ‘You’re trans, just when I’m going to start them on insulin.” Of course,
go ahead,’ even if they aren’t—and then they end gender dysphoria is listed in the DSM-5; juvenile dia-
up making mistakes that they can’t redo.” Delta’s betes is not.
gender dysphoria subsequently dissipated, though One recent study co-authored by Olson-Kennedy,
it’s unclear why. She started taking antidepressants published in the Journal of Adolescent Health, showed
in December, which seem to be working. I asked that her clinic is giving cross-sex hormones to kids as
Delta whether she thought her mental-health prob- young as 12. This presses against the boundaries of
lems and identity questioning were linked. “They the Endocrine Society’s guidelines, which state that
deinitely were,” she said. “Because once I actually while “there may be compelling reasons to initiate
started working on things, I got better and I didn’t sex hormone treatment prior to age 16 years … there
want anything to do with gender labels—I was ine is minimal published experience treating prior to
with just being me and not being a speciic thing.” 13.5 to 14 years of age.”

106 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
If you see gender-dysphoric 13- and
14-year-olds not as young people with a
condition that may or may not indicate
a permanent identity, but as trans kids,
full stop, it makes sense to want to grant
them access to transition resources as
quickly as possible. Olson-Kennedy said
that the majority of the patients she sees
do need that access. She said she sees a
small number of patients who desist or
later regret transitioning; those patients,
in her opinion, shouldn’t dictate the care
of others. She would like to see a radical
reshaping of care for TGNC young peo-
ple. “The way that the care has been orga-
nized is around assuring the certainty and
decreasing the discomfort of the profes-
sionals (usually cisgender) who deter-
mine if the young people are ready or not,”
she told me. “And that’s a broken model.”

O W B E S T T O support TGNC
H kids is a whiplash-inducing
subject. To understand even
just the small set of stories I encoun-
tered in my reporting—stories involving
relatively privileged white kids with car-
ing, involved families, none of which is
necessarily the case for all TGNC young
people in the United States—requires
keeping several seemingly conflict-
ing claims in mind. Some teenagers, in
the years ahead, are going to rush into
physically transitioning and may regret
it. Other teens will be prevented from
accessing hormones and will suffer
great anguish as a result. Along the way,
a heartbreaking number of trans and
gender- nonconforming teens will be
bullied and ostracized and will even end
their own lives.
Some LGBTQ advocates have called for gender relieve immense sufering. We recognize that there Delta, a patient of
dysphoria to be removed from the DSM-5, arguing is no one-size-its-all approach to treating anxiety Laura Edwards-Leeper
that its inclusion pathologizes being trans. But gen- or depression, and a strong case can be made that who wanted to
der dysphoria, as science currently understands it, the same logic should prevail with gender dysphoria. transition. Edwards-
Leeper counseled
is a painful condition that requires treatment to be Perhaps a irst step is to recognize detransitioners
her to take things
alleviated. Given the diversity of outcomes among and desisters as being on the same “side” as happily
slowly and to work
kids who experience dysphoria at one time or another, transitioned trans people. Members of each of these on her co-occurring
it’s hard to imagine a system without a standardized, groups have experienced gender dysphoria at some mental-health issues.
comprehensive diagnostic protocol, one designed to point, and all have a right to compassionate, compre- Her gender dysphoria
maximize good outcomes. hensive care, whether or not that includes hormones eventually lifted.
Experiencing gender dysphoria isn’t the same as or surgery. “The detransitioner is probably just as
experiencing anxiety or depression or psychological scarred by the system as the transitioner who didn’t
ailments, of course. But in certain ways it is similar: have access to transition,” Leibowitz told me. The
As with other psychiatric conditions, some people best way to build a system that fails fewer people is
experience dysphoria more acutely than others; to acknowledge the staggering complexity of gender
its severity can wax and wane within an individual dysphoria—and to acknowledge just how early we are
based on a variety of factors; it is in many cases inti- in the process of understanding it.
mately tied to an individual’s social and familial life.
For some people, it will pass; for others, it can be Jesse Singal is a contributing writer at New York
resolved without medical interventions; for still oth- magazine. His book about why bad behavioral science
ers, only the most thorough treatment available will goes viral will be published next year.

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 107
FOR
SEARCHING

JEAN-MICHEL

an art star,
ESSAY

Was he an artist,

or just a celebrity?

By Stephen Metcalf

EDO BERTOGLIO, JEAN-MICHEL BASQUIAT WEARING AN AMERICAN FOOTBALL HELMET (1981).


PHOTOGRAPH: © EDO BERTOGLIO; COURTESY OF MARIPOL. ARTWORK: © VG BILD-KUNST BONN,
T H E E STAT E O F J E A N - M I C H E L B A S Q U I AT; L I C E N S E D BY A R T E STA R , N E W YO R K .
T H E AT L A N T I C J U LY/AU G U ST 20 1 8 109
N M AY 2 0 1 6 , a painting by Jean- I wandered through the crowd talking of Gilles Deleuze and Félix Guattari, Leo-

I
Michel Basquiat sold for $57.3 mil- to the folks about the art. I had just nardo da Vinci, punk, postpunk, no wave,
lion. One year later, another one question. It was about emotional hip-hop, bebop, Lee “Scratch” Perry, Ein-
painting of his from 1982, Untitled, responses to the work. I asked, what stein on the Beach, Herman Melville, and
sold for $110.5 million, making it did people feel looking at Basquiat’s Jack Kerouac. The convergence of mul-
the sixth-most-expensive work of art paintings? No one I talked with tiple lines of inluence is apparent in Bas-
ever purchased at auction, and setting a answered the question. They went quiat’s work, and has been called a form of
record for an American artist. Basquiat is of on tangents, said what they liked “creolization,” and fair enough. But there’s
not the irst painter to have a canvas sell about him, recalled meetings, gener- creole, and then there’s the kitchen sink. If
for a price that strikes ordinary people ally talked about the show, but some- all of his creations were lost, and you had
as obscene. But when Jeffrey Deitch, a thing seemed to stand in the way, to reconstruct them going only on the
prominent curator and dealer, said after preventing them from spontaneously criticism, you would end up with some
the sale, “He’s now in the same league as articulating feelings the work evoked. abominable artwork.
Francis Bacon and Pablo Picasso,” it was What critics seem to be striving for on
hard to pin down the precise meaning of Standing before Jef Koons’s Balloon behalf of Basquiat isn’t understanding
the word league. Was Basquiat now con- Dog, you take a selfie. Before Untitled, but respectability, which anyone looking
sidered as great an artist as Picasso? Or which its owner is now exhibiting on a at the paintings can immediately see Bas-
was he merely as expensive to own? global tour, you … do what, exactly? A com- quiat was uninterested in. These canvases
Basquiat became famous in the early mon initial response—that the art is slap- were made by a young man, barely out of
1980s, when the idea that artists were dash, tender, true—feels wrong somehow, his teens, who never lost a teenager’s con-
supposed to be commercial innocents as if we haven’t gotten it. Unwilling to play tempt for respectability. Trying to assert
fell apart for good, and when the idea the part of the rearguard philistine any- art-historical importance on the paint-

U N T I T L E D ( 1 9 8 2 ) , AC RY L I C A N D O I L O N L I N E N . © VG B I L D - K U N ST B O N N , T H E E STAT E O F J E A N - M I C H E L B A S Q U I AT;
of the “art star”—a funnily ings’ behalf, a critic comes up

LICENSED BY ARTESTAR, NEW YORK; COURTESY OF THE MUSEUM BOIJMANS VAN BEUNINGEN. PHOTOGRAPH BY
abbreviated inversion, if you against their obvious lack of
think about it, of starving self-importance. Next to their
artist—irst came into vogue. louche irreverence, the lan-
In 1985, The New York Times guage surrounding them has
Magazine ran a cover story felt clumsy and overwrought
on Basquiat, titled “New Art, from the beginning. What
New Money.” Its tone was little we know for sure about
both awed and suspicious, Basquiat can be said simply:
with constant references An extraordinary painterly
to a hot, possibly gullible, sensitivity expressed itself in
market in contemporary art. the person of a young black
His work was said to be sell- male, the locus of terror and
ing “at a brisk pace—so brisk, misgiving in a racist society.
some observers joked, that That, and rich people love to
the paint was barely dry,” and collect his work. We have had a
Basquiat himself was quoted hard time making these two go
as worrying he had become a together easily. But so did he.
“gallery mascot.” Whatever For many years, the photos
else was true, as the art histo- accompanying the Times piece
By 1982, Basquiat’s use of color, surface, and line had grown more confident.
rian Jordana Moore Saggese supplied the public with its
has said since, “this was not image of the artist. Basquiat
the starving artist the public was accus- more, we stay quiet, stranded in a vaguely is dressed in an Armani suit, barefoot,
tomed to seeing.” shameful silence. In front of the painting, dreadlocked, paint-spattered. He looks—
In the 30 years since Basquiat died we fear we have seen or felt too little, espe- it’s hard to tell, he stares so blankly into
of a drug overdose, in 1988, at the age of cially given the $110.5 million price tag. the camera. With the beneit of hindsight
27, the prices of his work have climbed Basquiat’s works can also elicit the and some good reporting, we now know
steadily upward, taking some astonishing opposite response, very much in evidence that Basquiat was being crushed under
leaps along the way. Everyone remains in commentary on a recent retrospective money and publicity. At the very same
S T U D I O T R O M P, R O T T E R D A M .

fascinated by him—the life is compelling, mounted at the Barbican, in London, and time, he was being asked to reinvest paint-
the person bewitching, the canvases im- then at the Schirn Kunsthalle, in Frank- ing with its foregone aura of authenticity,
possible to turn away from—but nobody furt. Anxious to stake a claim for the paint- even saintliness, because he was black. No
agrees on why. His work seems to elicit ings’ place in art history, critics load them human being could have survived that,
one of two reactions from people. The up with extra signiication. I’ve seen the and he didn’t. The irony of his work’s ever-
first, as the writer bell hooks noticed following cited as inluences on, or analo- rising prices is that, far from clarifying his
when she attended a 1992 retrospective gies to, Basquiat’s work: action painting, stature, they keep alive the question he
of his work at the Whitney Museum, in art brut, surrealist automatism, William repeatedly asked himself: Am I an artist,
New York, is avoidance: Burroughs’s cut-ups, the schizoanalysis an art star, or just another celebrity?

110 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
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A S Q U I AT ’ S M O T H E R , Matilde, a friend, born of an impulse universal a slim volume that accompanied the irst

B was a Brooklynite of Puerto Rican


descent. In some accounts she is a
loving and nurturing igure, taking him
among teenage boys. As 17-year-old “Jean”
explained to The Village Voice, Samo was
designed as “a tool for mocking bogus-
public exhibition, in 2017, of the surviving
materials from that East 12th Street squat.
His terrain included “the walls and loor
to the Museum of Modern Art to see ness.” He kvelled at how the SoHo types of the apartment and the building’s hall-
Picasso’s Guernica and to the theater to had fallen for it. “They’re doing exactly ways, which were strewn with discarded
see West Side Story, giving him a copy what we thought they’d do,” he told the appliances.” Their apartment is described
of Gray’s Anatomy. (All of these appear reporter. “We tried to make it sound pro- as a heavenly cocoon, overlooking the
as touchstones in his work.) In other found and they think it actually is!” It’s “shooting galleries,” the drug dens of Ave-
accounts she is erratic, beating him hard, reading the piece now, not to hear nue B. They went dancing every night.
for wearing his underwear backwards, him talking back to the blue blazer: “Art was life and life was art,” Adler wrote.
threatening to kill her entire family with A new documentary, Boom For Real:
a jerk of the steering wheel. Basquiat This city is crawling with uptight, The Late Teenage Years of Jean-Michel
once said his mother carried “a worry middle-class pseudos trying to look Basquiat, made with the cooperation of
line on her forehead from worrying too like the money they don’t have. Sta- Adler, expands on a now-familiar story.
much.” He called her a bruja, a “sorcer- tus symbols. It cracks me up. It’s like “One week ago New York City tottered on
ess.” She was in and out of mental hospi- they’re walking around with price the brink of inancial default,” President
tals. He told one interviewer: “She went tags stapled to their heads. People Gerald Ford intones over the opening
crazy as a result of a bad marriage.” should live more spiritually, man. But montage of a busted-up and burning city.
His father, Gerard, was a Haitian we can’t stand on the sidewalk all day During this period, we’re told, a tiny sub-
immigrant. He was upwardly mobile, screaming at people to clean up their set of young people, leeing boring lives
middle class, and professional, and he acts, so we write on walls. elsewhere, gravitated to the lawlessness
wanted to instill middle-class values in and decay and created their own urban
his oldest child. His oldest child wanted In 1979, he gained “his first stable village. The streets may have been dan-
none of it. Gerard Basquiat reportedly home,” says Alexis Adler, his roommate gerous, but that encouraged a sociable
once beat his son so severely that Jean- from the time, “the irst place he had a key and intimate scene.

© VG B I L D - K U N ST B O N N , T H E E STAT E O F J E A N - M I C H E L B A S Q U I AT; L I C E N S E D BY A R T E STA R , N E W YO R K .


Michel went to school the next day walk- to.” He was 18; she was 22. In their sixth- The streets were as much Basquiat’s
ing with a cane. (Gerard has denied this.) loor walk-up, Basquiat began to make the home, apparently, as the squat, and
Other times, the story goes, he was so transition from street tagger to gallery art- the work he made reflects this fact. He
badly beaten that he called the police. ist. “He wrote and drew on any surface,” scrawled on detritus fished from the
His parents separated permanently when Adler recalled in Basquiat Before Basquiat, neighborhood, on discarded scraps of
he was 7, and his father later moved him
and his two younger sisters from East
Flatbush to a townhouse in Boerum

G L E N N ( 1 9 8 4 ) , A C R Y L I C , O I L S T I C K , A N D P H O T O C O P Y, C O L L A G E O N C A N V A S .
Hill. Gerard, who always insisted that
the Basquiats had been an elite family in
Haiti, obtained a night-school degree in
accounting and eventually became the
comptroller for the Macmillan publish-
ing company.
In their new neighborhood, Gerard
played the happy divorcé, in a blue blazer
with brass buttons, driving a Mercedes-
Benz. Jean-Michel disappeared into the
crawl space beneath the staircase, cover-
ing it in his drawings. What art Basquiat
made, and how he made it, remained
closely bound up in his own unsettled
relationship to real estate. He ran away at
least twice before leaving home for good
at 17. That meant—and here something of
a mythical fog descends—living in Wash-
ington Square Park and leabag hotels, and
rotating through the sofas and beds of vari-
ous friends and lovers.
He began his life as an artist spray-
painting tantalizing koans on the walls in
and around SoHo under the pseudonym
Samo, short for “same old shit.” His work Basquiat’s early streetscapes gave way to collage-based work featuring the human figure.
as Samo was a collaborative project with

112 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C
“A fascinating account of one of our
canvas or a torn-of apartment door, illus-
trating them with street action: car acci- country’s great historical mysteries.”
dents, ambulances, skylines. These works
are very crude—they scarcely even count
NATHANIEL PHILBRICK,
as juvenilia—but they are also very sweet, bestselling author of Valiant Ambition and Mayflower
and contain hints of what was coming. He
began crossing out words as a way to draw
attention to them. He was also developing

Basquiat became famous


in the early 1980s,
when the idea that artists
were supposed to be
commercial innocents
fell apart for good.
a set of symbols that remained important
throughout his career—among them the
copyright symbol. It was meant ironically,
given that Samo’s work was very much in
the public domain. Once he started work-
ing indoors, the symbols began to take on
a diferent irony, at once darker and more
fragile. Is this work mine? Should I use my
given name instead of the Samo tag? If so, will
it make me money?
As Basquiat moved toward more con-
ventional painting, he transitioned from
streetscapes to human figures. These “Andrew Lawler turns Roanoke into one of
are shown frontally, with little or no
depth of ield, and nerves and organs are our history’s best stories, recounting not only the
exposed, as in an anatomy textbook. Are fascinating, little-known history of the colony itself but
these creatures dead and being clinically
that of the incredible swirl of historians, archaeologists,
dissected, one wonders, or alive and in
immense pain? hoaxers, and experts on arcane subjects who have been
caught up in the quest to find it.”
D L E R A N D B A S Q U I A T lived

A together on East 12th Street from


the fall of 1979 to the summer of
1980. That June, he exhibited his work for
—Charles Mann, bestselling author of 1491

“The most enduring riddle of American history,


the irst time: He painted a mural inside reveals more about who we are today than
the “Times Square Show,” the legendary
the actual fate of the doomed expedition of 1587.”
event held in a former massage parlor
of Seventh Avenue. The show featured —Rinker Buck, author of The Oregon Trail and Flight of Passage
performance art, graiti, ilm, and a car-
nival atmosphere. But it was Basquiat’s
contribution that was singled out in Art “Riveting and carefully researched….
in America. (“A patch of wall painted by Lawler takes us inside one of the oldest and most
SAMO, the omnipresent graiti sloganeer,
intoxicating mysteries in American history.”
was a knockout combination of de Koon-
ing and subway paint scribbles.”) The fol- —Candice Millard, bestselling author of Hero of the Empire
lowing February, Basquiat was included
in the “New York/New Wave” show at
PS1, the nonproit arts space housed in a
— Illustrated throughout with maps and photographs —
defunct elementary school in Long Island Available wherever books are sold
Doubleday Also available in audio and eBook formats www.andrewlawler.com
SIGN UP FOR City. Of more than 100 artists, he was the
only one to be given a prominent space
crown, appears more often, but what is it,
exactly? An Apollonian laurel wreath, the
“THE FAMILY WEEKLY” for paintings. He showed more than 20
works on their own wall in the inal room
ultimate symbol of victory and honor? Or
a crown of thorns, which, along with the
NEWSLETTER of the show.
His paintings, the art dealer Annina
cross, is Christendom’s ultimate symbol
of humiliation and mockery?
See how families Nosei later said, “had a quality you don’t Basquiat worked several canvases at
are changing. find on the walls of the street, a qual- once, dancing from surface to surface
ity of poetry and a universal message of like “Ali in his prime,” according to an
the sign. It was a bit immature, but very assistant. He could finish two or three
beautiful.” Nosei’s background in the in a day. Sometimes he would paint in
art world was deep—she had worked for pajamas and slippers. At intervals, one of
the eminent dealer Ileana Sonnabend, Nosei’s assistants would walk him over to
toured the country with John Cage, met a Citibank to provide him with cash.
her husband through Robert Rauschen-
berg. Her connection to Basquiat’s work A I N T I NG S H AV E BE E N tradable
was instantaneous and serious. She was
frantic to represent him, but there was a
hitch. Other than what he’d exhibited, he
P commodities since at least the 16th
century, and by the middle of the
17th century, something like an inter-
had no paintings. Visiting Basquiat (dif- national market in art was up and run-
ferent apartment, new girlfriend), Nosei ning. It dealt mostly in antiquities and
was floored to discover that he had no old masters, and was small and illiquid.
inventory to show her. “You don’t have When a trade in modern art irst arose, in
anything?” she asked him, as she recalls in the late 19th century, it was deined by an
a 2010 documentary called The Radiant absence of heat or velocity. An art dealer
theatlantic.com/family Child. And so, in September 1981, Nosei discovered unknown artists, then sup-
put him to work producing canvases in ported them through years, even decades,
her Prince Street gallery’s basement. of obscurity. “We would have died of hun-
The arrangement understandably ger without [Paul] Durand-Ruel, all we
makes commentators squirm: a white Impressionists,” Claude Monet famously
taskmistress keeping a black ward in her said of the renowned dealer.
basement to turn out paintings on com- Modern art was once deemed serious
mand. Basquiat himself said, “That has because it derived from an avant-garde,
a nasty edge to it, you know? I was never and what the garde was in avant of was
locked anywhere. If I was white, they the market. This much is plain if you read
would just say ‘artist in residence.’ ” With the memoirs of Durand-Ruel, and of his
its large, oblong skylight, the space was successors Ambroise Vollard and Daniel-
neither gloomy nor cramped, and it was Henry Kahnweiler, the original dealers
continuously restocked with supplies in modern art. All three acknowledge
by fawning assistants. Basquiat treated the market, and Durand-Ruel and Vol-
the arrangement like a job. Nosei recalls lard make constant reference to prices.
him showing up early in the morning Kahnweiler invoked Picasso’s dictum:
with croissants from Dean & DeLuca “For paintings to be worth a lot of money,
and apologizing if he was late. Once in they must at some point have been sold
the basement, he would put on music, cheaply.” Artistic validation was a pro-
often Ravel’s Boléro, incurring the bang cess, a struggle that entailed trial and con-
MODERN MEMOIRS, INC. of Nosei’s umbrella from the loor above. demnation by the market, then triumphs
As-told-to memoirs &
And then he would paint. in the market, which over time revealed
self-publishing services Here his work begins to mature so the “true” value of the work in high, and
since 1994 quickly, so decisively, one can scarcely inally exorbitant, sale prices.
4 13 - 2 5 3 - 2 3 5 3
process it. At the same time, race The appearance of the art market as
enters his work more explicitly. In Irony we now know it has been traced to the
of Negro Police man, Basquiat offers early 1970s, and to one auction in par-
his own excruciatingly personal take on ticular. In 1973, Robert Scull, a New York
what W. E. B. Du Bois famously called taxi tycoon, sold of 50 works of contem-
They’re here! “double-consciousness.” Elsewhere, porary art. At the auction, Double White
black men for him are at once virtuosos Map, an encaustic collage by Jasper
and martyrs, Dizzy Gillespie and Sugar Johns, sold for $240,000. For Scull, this
Ray Robinson featured prominently represented a 2,250 percent return on his
among them. His favored symbol, the money in eight years. As the sociologist

114
The Skeptic’s Guide
to American History
E D TIME OF Taught by Professor Mark A. Stoler
IT THE UNIVERSITY OF VERMONT

FE
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LECTURE TITLES

R
70% 1. Religious Toleration in Colonial America?

R 7
off 2. Neither American nor Revolutionary?

OR

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3. The Constitution Did Not Create a Democracy
ER

D
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BY S E P T E 4. Washington—Failures and Real Accomplishments
5. Confusions about Jeferson and Hamilton
6. Andrew Jackson—An Odd Symbol of Democracy
7. The Second Great Awakening—Enduring Impacts
8. Did Slavery Really Cause the Civil War?
9. The Civil War’s Actual Turning Points
10. The Myth of Laissez-Faire
11. Misconceptions about the Original Populists
12. Labor in America—A Strange History
13. Myths about American Isolation and Empire
14. Early Progressives Were Not Liberals
15. Woodrow Wilson and the Rating of Presidents
16. The Roaring Twenties Reconsidered
17. Hoover and the Great Depression Revisited
18. What Did Roosevelt’s New Deal Really Do?
19. World War II Misconceptions and Myths
20. Was the Cold War Inevitable?
21. The Real Blunders of the Vietnam War
22. Myths about American Wars

What Really Happened 23. Who Matters in American History?


24. History Did Not Begin with Us

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Olav Velthuis discovered through exten- work for him, supplies, and, waiting at the
sive interviewing, dealers and artists end of this pipeline, collectors to buy his
point to this as the moment when the “art art. Basquiat had arrived, but he, at least,
market proper [turned] into a commodity didn’t seem sure where.
or investment market.” The Crosby Street loft was on the sec-
And then, in September 1980, the Jas- ond floor, and visitors would either hit
per Johns painting Three Flags was sold to the buzzer, which Basquiat had labeled
Darwin Panama the Whitney Museum for $1 million. This TAR in trademark Samo handwriting, or
A warm weather hat with Australian was a record price for a work by a living call up from the street. Collectors would
styling, handwoven in Ecuador from artist, though it wasn’t only the money drop in, and if they wondered aloud
toquilla iber. Braided kangaroo leather that made the sale notable. A Connecticut whether a painting might blend in with
band. Reinforced 4½" crown, 3" brim. couple, the Tremaines, had acquired Three their decor, Basquiat would chase them
Finished in USA. Flags in 1959, for $900, from the legendary away, often hurling abuse, or sometimes
art dealer Leo Castelli. Selling it, they had food—cereal, rice, milk—from the win-
S (6¾-6⅞) M (7-7⅛) L (7¼-7⅜)
bypassed him completely; and this, Cas- dow down on their heads. Graffiti kids,
XL (7½-7⅝) XXL (7¾)
telli felt, violated the established courte- groupies, celebrities, and, not least, drug
#1649 Darwin Panama $139 delivered sies of his profession. buddies—people came day and night
Shop online or request a catalog Castelli had presided over a market that and found a space strewed with art, gar-
#KBE-13-FH was not a free market at all. It was a ield bage, toys, magazines, books. A Haitian
of action dense with personal meaning— voodoo statue stood in a corner. The bed
#1622 #1648
handshake agreements, favoritism (in the had a polyester Superman comforter and
form of a waiting list and some genteel a cocaine mirror on the headboard shelf.
price discrimination), and, most crucial, Reports from this period converge on two
a blacklist of collectors who resold works. details: The television was always on, and
^
800-324-4934 davidmorgan.com
Together these customs restricted supply,
protecting collectors from a looded mar-
the fridge was always illed with gourmet
sundries—chocolates, pastries, Russian
ket while keeping ultimate jurisdiction caviar—slowly going bad.
11812 N Creek Pkwy N, Ste 103•Bothell, WA 98011
over a painter’s career in the hands of his Basquiat’s girlfriend at the time,
dealer. “It was bucolic,” Castelli said of the Suzanne Mallouk, remembers him cover-
period. “Money was not so important.” ing the windows with black paper, banish-
Autobiography of a Yogi The sale of Three Flags made the front ing daytime from the living space and the
page of The New York Times. It heralded, internal clock from their bodies. They did
Velthuis has argued, the arrival of “super- more and more coke, and Basquiat began
“A timeless
star prices” in contemporary art. By late freebasing. Along with drugs, renown,
classic 1982, thanks in part to the onset of the hangers-on, and paranoia, money was
in spiritual Reagan-era economic boom, a period now a force in his life, and large bills were
literature.” of reckless, almost spastic, buying had stufed in books and under the carpet, or
-DEEPAK CHOPRA begun in earnest. Whatever else was true, left to drift where they may. Basquiat
the garde was no longer avant, and prices once binged on expensive electronics,
The life story of were rising fast. In 1983, Julian Schnabel’s then sat on the loor surrounded by his
Paramahansa Notre Dame was auctioned at Sotheby’s latest gadgets and cried.
Yogananda for a winning bid of $93,000—a three- In March of 1982, he exhibited work
year return on investment of more than he had made in Nosei’s basement—Arroz
SRFbooks.org 2,500 percent. Relationships between con Pollo, Crowns (Peso Neto), Untitled (Per
artists and dealers were becoming more Capita)—in the upstairs of her gallery.
nakedly transactional. When the painter This was his irst solo show in the United
Roll-up Panama $110 and sculptor Donald Judd left the presti- States, and his irst solo show as Basquiat.
Handwoven straw. Made in Ecuador.
Sizes: S - 2XL. Ideal traveling sun hat. gious dealer Paula Cooper for the Pace (He had recently shown as Samo in Italy.)
Colors: dark natural or light natural. Gallery, Cooper said, “Artists today are It sold out in one night. He was 21 years
Check or credit card w/ exp. date.
Add $15 S/H. www.johnhelmer.com like baseball stars.” old. He followed up his debut in New York
John Helmer • Est. 1921 • (503) 223-4976 City with a mob-scene opening in Los
969 S.W. Broadway, Dept. T078 • Portland, OR 97205 N O C T O BE R 1 9 8 1 , Nosei included Angeles, and a solo show at the Galerie

/,7(5$5<$:$5'6
6(1')25285)5((%52&+85(
I Basquiat in a group show. She gave his
six paintings the entire back room of
her gallery, and after his work sold, she
Bruno Bischoberger, in Switzerland.
Shortly after his triumph, he was lown
back to Italy, and in an airplane hangar in
(DWRQ/LWHUDU\$JHQF\ was ready to make another proposal. the industrial outskirts of Modena, Bas-
32%R[ She ofered, in a stroke, to put the entire quiat was deposited in front of massive
6DUDVRWD)/ apparatus of the working artist in place 25-by-15-foot canvases, stretched and
ZZZHDWRQOLWHUDU\FRP around him. She would give him a loft to ready, and was given just days to pro-
 live in, a studio to paint in, assistants to duce fresh material for a second Italian

116
opening. He was attended by his Italian
dealer, as well as by Nosei and Bischof-
berger. “They set it up for me so I’d have
to make eight paintings in a week,” he
later told The New York Times Magazine. “I
WhiteWalls
Steel Whiteboard Wall Panels
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made them in this big warehouse … It was


like a factory, a sick factory.”
Two months later, he snuck into
Nosei’s basement and destroyed 10 of his
canvases. Using a box cutter, he slashed
them down to rags, and then, as if to
make sure that they could never be resur-
rected as salable art, he doused them with
a bucket of white paint.

HEN I SAW “Basquiat: Boom For

W Real,” the major retrospective of


his work that recently closed
in Frankfurt, the exhibit was not only
well, but reverentially, attended. View-
ers paused over items as if they were
holy relics. (Someone knew to save this, I "You wouldn’t believe how much creativity is sparked when
thought over and over.) The presentation
you have the entire room as your writing surface"
lowed gracefully from Samo to the East
12th Street material through to the danse Office Manager, Label Manufacturer, Brea CA
macabre of his last major works. Mostly
glossed over in the catalog commentary WhiteWalls.com 800-624-4154
and exhibit photographs was the fact

He slashed his canvases


down to rags, and then,
as if to make sure
they could never be
resurrected as salable
art, he doused them with LOVE
a bucket of white paint.
that, after he became famous, Basquiat THE
ATLANTIC?
went, in quick and ghastly succession,
from sweet East Village magpie to café-
society boor to dead. The artist who pre-
sided at the show instead is the pre-boom
Basquiat, the marvel of a crumbling yet
vibrantly creative New York City. What is
he being made innocent of here if not the Get more from us on Facebook,
market, the 1980s art market in particu-
lar? Yet to make him innocent of the mar- Instagram, and Twitter.
ket is to cleave him in two, and discard the
struggle that deined him as an artist.
By early 1982, Basquiat had plainly
entered a new phase. He started replacing
, H  @TheAtlantic
the incidental crud of his surfaces—torn
bits of paper aixed with glue, sneaker
prints—with something more calcu-
lated, deploying techniques of collaging

T H E AT L A N T I C J U LY/AU G U ST 2 0 1 8 117
reminiscent of Rauschenberg’s. His use To insist that Basquiat was a virtuoso martyrdom of the black virtuoso the sub-
of color, surface, and line to achieve is to turn away from the paintings all over ject of his work. To be the irst black artist
expression istic affect showed a new- again, to miss their ultimate dare. The who was not a black artist, while never
found conidence. At the same time, he search for authenticity of form and feel- not being a black artist: This is to make
was suddenly making paintings for the ing that led white artists toward naive of yourself a holy singularity.
market, and making a lot of them quickly (even childish) techniques and human
and under pressure. primitives—what does that quest mean H E N E W O W N E R of Untitled,
The result was a heroic mastery
combined with the randomness of trash
buoyed in the wind. Basquiat became
when a black artist pursues it? It’s a good
question, a biting one, and we’ve become
accustomed to asking it of Basquiat while
T Yusa ku Maezawa, has indicated
that the proper fate of the paint-
ing is not to be hoarded, but to be seen.
frenetic in his inclusion of materials he leaving the follow-up hanging in the air: I went to see the single-painting show
found ready to hand, illing his canvases What does it mean when a black artist “One Basquiat” in March, at the irst stop
with yet more symbols: renditions of dol- vaults altogether beyond technique, or on its global tour, the Brooklyn Museum.
lar signs, coins, Federal Reserve notes, formal training, or deep study? On his The viewing room was chapel-like. At
Japanese yen, Afro-Cuban ideograms, canvases, Basquiat turned to the black ath- the near end, a glass case held Basquiat’s
logos, cars, airplanes, feathers, feet, letes and musicians he venerated, to Hank junior museum membership card. On
skulls. To do this, he grabbed at anything Aaron and Charlie Parker. They were the the far wall hung the most expensive (for
that might serve as raw material—from now) artwork by an American.
Henry Dreyfuss’s Symbol Sourcebook: Viewers feel stared at by Basquiat’s
An Authoritative Guide to International What does it mean when paintings, one commentator has said, and
Graphic Symbols to the 1980 catalog of
the Met’s permanent collection. By 1984,
a black artist vaults I agree. But in their presence, I also have
the feeling of happening upon something
his collaging technique had become more
sophisticated. He’d sometimes layer the
altogether beyond I was never supposed to see. Basquiat’s
art was made under conditions that, one
canvas densely with color photocopies, technique, or formal has to believe, are anomalous in the his-
which he would then paint over. He even tory of art, and yet we would apply to it the
began using Andy Warhol’s trick of silk- training, or deep study? traditional standards and vocabularies of
screening to repeat images both within art history. On the one hand, Basquiat
and between canvases. consummate virtuosos, yet Aaron was was a heroic master like Picasso, even
Warhol reported in his diaries that viliied when he displaced Babe Ruth, the though he was rushed to market before
when Bischoberger irst saw these works greatest of white American athletes, as he could fully develop his mastery. On
he gave them a “sour look.” The approach the home-run king in the sport that is a the other hand, we need him to be one of
had “ruined [Basquiat’s] ‘intuitive primi- stand-in for national innocence. Parker, the ultimate authentics, à la Vincent van
tivism.’ ” There is a kernel of truth even to as one of the pioneers of postwar bebop, Gogh, even though he interacted directly
this casual racism. Inevitably, words like took “Negro genius” to abstruse places it and on a continuous basis with the mar-
primitive, unschooled, undisciplined are per- was never supposed to go. ket. To this day, he is asked to restore the
ilous, given how carefully vetted Basquiat What does it mean to have depicted symbolic capital of the starving artist to a
criticism is for ofensiveness. Yet if you are them in paintings that are easily mis- system that otherwise does everything in
afraid, you will never understand who he read as lazy, among the most loaded of its power to destroy it. And so he remains,
was or what he was getting at. The curators racist terms? Black American genius has to this day, a perpetually uncertain thing.
and critics of “Basquiat: Boom For Real” long been forced into music and sports, Untitled, an agonized skull from the
tried running in the opposite direction, where it has been asked to further vindi- Crosby Street period, was irst purchased
describing him as a maestro in all things, cate itself by displaying a total virtuosity, in 1984 for $19,000. At its recent sale price,
with one contributor to the catalog go- only to be martyred when that genius it had increased in value by 581,479 per-
ing so far as to call him an “extraordinary breaks out of the mold that respectability cent. One shakes one’s head in disbelief
painter and draughtsman.” But Basquiat and conformity has made for it. Basquiat and thinks: Whatever the market will bear.
wasn’t even a good draughtsman, and he refused to play that game. First, he At the same time, one bows one’s head in
cheerfully admitted it. It is useless to pre- rejected the role of ingratiating virtuoso, awe and thinks: Worth every penny.
tend otherwise: Unlike Jean Dubufet, he placing himself instead within the lin-
made unschooled images because he was eage of the (white) modernist genius, Stephen Metcalf, the host of Slate’s
unschooled. Unlike Picasso’s, his igures of “Twombly, Rauschenberg, Warhol, Culture Gabfest podcast, is at work on a
were crude because he could barely draw. Johns,” as he said. Then he made the book about the 1980s.

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THE BIG QUESTION

Q:
What book or article
would you make
required reading for astoundingly visionary satire Don Marine,
everyone on Earth? published in 1932 that fore-
saw not just what’s happen-
Sun City West, Ariz.
Maya Angelou’s poem
ing today, but where we’re “Human Family.” Her
Carey Cranston, a world where we all live by possibly heading next. signature plea, “We are more
president, American this covenant: Be impeccable alike, my friends, / than
Writers Museum with your word; don’t take Marley Dias, founder, unalike,” is truly universal.
Narrative of the Life of anything personally; don’t #1000BlackGirlBooks
Frederick Douglass, an make assumptions; always Dr. Seuss’s Yertle the Tur- Nancy Hawley,
American Slave illustrates do your best. tle shows the consequences Spokane, Wash.
the greatest heights and of abusing power. Yertle the I suggest The World
the lowest depths of Ameri- Turtle yelled and screamed According to Mister Rogers,
ca’s history and potential, at those who supported him, by Fred Rogers, because we
while, better than any other and his lack of gratitude led all need to practice kindness,
work, showing the power of to his fall from power. The tolerance, and respect.
literacy—that when a person book can teach all of us that
can read and write, he gains as we rise, we need to thank
the ability to create his own and uplift those who help us.
narrative, and to shape his life
and the surrounding world. Esmeralda Santiago,
author, Conquistadora
Michiko Kakutani, Susanna Fogel, director Men speak about peace but
literary critic and co-writer, The Spy prefer war. Men head the
Shakespeare’s collected Who Dumped Me majority of governments
plays. Four hundred years The Frog and Toad series, and control the increas- Robert Murphy,
after the playwright’s death, by Arnold Lobel. Though ingly lethal weapons, using Tarpon Springs, Fla.
his inluence spans the ostensibly children’s books, women and gods as moral The Book of Exodus
planet. He was uncannily they frame depression and shields. Unsparing in its should be required reading
modern in his inventive- anxiety in the most relat- portrayal of men’s nature, in an era of refugees, climate
ness and gift for engaging able way possible. The two The Iliad should be read change, and failed leader-
the popular imagination; amphibians—one an intro- by everyone who hopes to ship. Pharaoh was paranoid
in his depiction of spirited, verted cynic who can’t understand mankind. about homeland security,
independent women; and in stay present, the other an and he didn’t like pluralism.
his appreciation of the con- emotional-novelty addict— READER RESPONSES Something went wrong in
tingencies of life in a chaotic have a sweet, enduring Gary Kohl, the environment, and the
world reeling from accelerat- friendship. Both worldviews Toronto, Canada government collapsed.
ing change and loss. are valid! Dr. Seuss’s commentary on
industry and the environment,
Want to see your name on this page?
Imbolo Mbue, author, Kevin Kwan, author, The Lorax—because unless Email bigquestion@theatlantic.com
Behold the Dreamers Crazy Rich Asians each of us “cares a whole with your response to the question for
our October issue: What would you
Don Miguel Ruiz’s The Brave New World, by awful lot, nothing is going to designate as the eighth wonder of
Four Agreements. Imagine Aldous Huxley, is an get better. It’s not.” the world?

120 J U LY/AU G U ST 2 0 1 8 T H E AT L A N T I C Illustrations by GRAHAM ROUMIEU


www.grand-seiko.us.com